in such a manner that the lungs gradually push the diafram downward and elevate the abdomen. Instruct the patient to do this deep breathing exercize every night and morning for twenty times while undrest, and as often as possible during the day. Hav her watch the hand and see how high she can elevate the abdomen during inhalation. This centers the mind on the exercize, which is of great importance. In- hale slowly, occupying about four seconds. Hold the breth at least twice as long as it required to take it in, and take as much time to exhale as the breth is held. This tends to open up the alveole of the lungs and increase lung expansion. Rythmic breathing—counting four while inhaling thru the nose, holding the breth while counting eight, exhaling thru the nose while counting eight—I find to be the ideal system. While doing the deep breathing exercize, hav plenty of fresh air in the room. After this exercize has been prac- tist for a few weeks, the patient wil notis that she breathes more and more deeply without being conscious of it. By Passiv Exercize is ment that form of exercize which does not require the application of the patient's wil. It includes Massage, Vibration, and Mecanical Manipulation. To improve the nutrition of any muscle or set of mus- cles, giv such exercize as to contract same and giv them time to react. Many modalities ar employd to improve the tone of a muscle, when in reality the muscle is impaird, because of the manner of the application. The prevailing faulty tec- nic in exercize is overdoing the treatment or making the stimulus so rapid that the muscles cannot come back to rest before the succeding stimulus is applied. During any exercize, encourage deep breathing. This aids in throwing off the extra catabolic products. Be careful in giving or prescribing too hevy exercize of any kind to persons past thirty years of age. Exercizes which increase the tone and contraction of the abdominal muscles wil go a long ways towards driving away “‘the blues.” Flexion and extension against resistance wil do much in the way of bring- ing blood to the parts and increasing the tone of the muscles. Tt has been proved that the mind has a great effect upon the nutrition and development of muscles. It is for this reason that all exercizes should be done, as much as possible, before a mirror. This causes the individual to watch just what is taking place. 573The following ar some Special Exercizes that I hav found beneficial : Referring to Fig. 195, .4 and B represent the thigh- flexing exercizes to be taken before arising. It is not neces- JS LERNER Fig. 195 A, thigh and leg flexion; B, thigh and leg extension; C, left thigh ion; D, right thigh flexion; E, both thighs flext; F, flexing trunk on ; poise for neck extension; H, jaw extension; J, walking on-all- fours; I,'nee-chest position, 574sary to hav a football suspended over the foot of the bed, but the illustration shows how this exercize is to be carried out. Do not allow the feet to drop while doing this exercise. C and D represent the alternate raising and lowering of the right and left leg. E represents the raising of both legs together. F represents the feet held down by the bedclothes and the trunk flext on the thighs in the manner illustrated. After one becomes proficient in this exercize of flexing the trunk on the thighs, it can be done without any weight on the feet. Each of these exercizes should be repeated from five to twenty times every morning. Extending the neck as in G, having the hands about the waist with thums to the back, is the exercize for stimulating the sympathetic-vagal reflex, and is especially indicated in goiter and in hart disease. It is also very beneficial for strengthening the vocal cords and developing the neck. This exercize is executed in the following manner: With the neck flext, slowly extend it until looking strait at the ceiling. Then just as s/owly bring it back to the flext position again. This special exercize should be re- peated twenty times or more twice daily. 1 in the same Fig. represents hyper-extension of the lower jaw. The hands should be placed as in Fig. G. This exercize is of markt benefit for public speakers, elocutionists, and singers. It is also very beneficial for strengthening the vocal cords and for stimulating the tonsils and salivary glands. This exercize should be done while alone, and the open- ing and closing of the jaw should be carried on slowly. The reason it should always be done when alone and systematic- ally is to prevent acquiring a habit tic of opening the jaw. This special exercize should be repeated at least twenty times or more twice daily. The special exercize J represents the nee-chest position which every physician knows. For retroversion, the proper tecnic is to let air into the vagina after this position is as- sumed, and then hold the position for 10 or 15 minutes. Then with the thighs closed, roll over on the left or right side, according to circumstances, just before going to sleep. The uterus wil often hold its forward position until the patient rises. 575J represents walking on-all-fours. This exercize is probably one of the best exercizes for women with weak abdominal muscles or for relaxt pelvic ligaments. It is also the exercize par excellence for a pregnant woman. This exercize should be taken every night and morning without any clothes on or with only a pair of trunks. The distance may include a hundred steps or more. This same exercize can be modified by having the hands and feet in a fixt position, as shown in Fig. J and lowering the abdomen until it touches the floor and then raising it. Fig. 196. The Simplex Spirometer. This instrument can be procured form any physicians’ supply house. For hung exercizing it is invaluable. THE SPIROMETER For testing the capacity of a new patient's lungs, and to watch the progress of their increase, I use a Spirometer. This is illustrated in Fig 196. I find this a very valuable little instrument. For many patients I prescribe a spirometer to hav in their rooms and watch the development of their lungs. My instructions ar to hang the spirometer on a hook securely fastend to the wall about the height of the shoulders and situated so as not to come in contact with doors or movable furniture. 576Thoroly ventilate the room and allow the entrance of all the fresh air possible, wether permitting, in order that the lungs may be ventilated and the exercize invigorating. Remove all clothing that tends to bind chest, waist or abdomen or keeps them from expanding freely—belts and corsets especially must be laid aside. Keep the shoulders turnd backwards and be careful not to raise the shoulder blades or collar bone, keeping all the muscles flexible. At each test, hav the hand point to the figure “O” turn- ing it to the right or left by means of the nickeld hub. Averace Lune Capacities Cubic Inches 577Parr Four. Lecrure II. EXERCIZES FOR THE PHYSICIAN, FOR HIS PATIENTS, AND FOR EVERYONE WHO WANTS TO CHUM WITH HELTH If the physician does not know how to gain helth and how to keep it, how can he teach his patients ? As so many physicians ar very ignorant on this most important subject, and as I wanted to giv my readers the very best on this “moving subject," I askt the best specialist in vigor that I know of to write this lecture. Fig. 197 I now take plesure in introducing to you (if you ar not alredy one of the thousands who know him), Prof. E. B. Warman of Los Angeles. As this young man is rather back- ward in putting himself forward (except in running), he presents his back to you at the prattling age of seventy (70) years (Fig. 197). As his pride is in his back, which he can 579easily back up, he gave me a small picture of his face and askt to show that later on.* PREFACE After forty-one years of experience and observation regarding Fysical Exercizes, I hav arrived at the following conclusion, viz.: the average person seeking helth, thru exercize, becomes very enthusiastic (for a few days) over any and every “new” system, practises faithfully during the time and then drops the whole thing. Why? Because all extensiv systems (my own not ex- cepted) contain more than the average person has time or inclination to follow daily, unless he is preparing to become a specialist in this particular field. Therefore, I hav chosen from my own system of Fysi- cal Education (Tensing) the exercizes J take invariably, every morning; such exercizes as may be taken in twenty minutes; such exercizes as wil, with right living, put and keep the human machinery in good running order; such exercizes as may be taken with benefit by the child of six or the child of seventy-six. These exercizes ar fully illustrated herein and given in the order as I take them every day of the year. Do thou likewise and years wil be added unto thy life and life unto thy years. GENERAL DirecTIONs Do not hold the breth during an exercize. Contract the muscle as tho overcoming a natural resistance. When the muscle is brot to its greatest tension, it should be held a moment and then relaxt. After becoming familiar with the movements, the time required to take all the exercizes wil not excede twenty minutes. Correct position of the body when standing and sitting, and correct carriage of the body when walking, together *Most of the exercizes and remarks here given, which ar a prelude to Prof. Warman’s special contribution, ar in a small book entitled “Twenty Minute Exercizes,” by E. B. Warman, AM. LL.D. Los Angeles, Cal., publisht by American Sports Publishing Co, 21 Warren Street, New York City, and sold at all Spaulding Sporting Goods Stores in the United States. 580with ful, deep breathing and right living, ar essential to HELTH. The exercizes, to be of the greatest benefit, should become a daily habit. The minutes faithfully spent now wil reward you in years by and by. START YOUR DAY RIGHT Do not jump out of bed when awakening. No machine is ever started at ful speed except the human machine (and that breaks the cogs). Lie flat on the back. Stretch the entire body, tensing and relaxing the muscles of the neck, arms, back, chest, abdomen, and legs. This increases hart action and causes arterial distension in the most natural and effectiv manner. After arising clense the teeth, rinse the mouth, gargle, drink one or two glasses of cold water, then take the follow- ing exercizes in the order given. Take them vigorously but not violently. Follow the exercizes with a suitable bath or rub down such as is best suited to the patient. Some can react wel to a cold or tepid shower, but one should use great discretion in prescribing baths. Never take a hot bath in the morning.és atl (6 es A ‘opposit.For Neck, Upper Cuesr ano Back (See Fig. 198, opposit) Figs. d and B. Body erect; hed wel poisd. Move hed forward and down (slowly), pressing chin to chest; then up, back and down. In both cases as far as possible, and then some. 15 times each way without stopping. Figs. C and D. Body erect; hed wel poisd. Move hed toward right and left side, slowly, without turning the hed. Try to touch ear to shoulder, without raising the shoulder or swaying the body. 10 times each way without stopping. Figs. E and F. Body erect; hed wel poisd. Turn hed to right and left, very slowly, until chin is over shoulder. Do not tip the hed forward or backward when turning. Do not turn the body. 5 times each way without stopping. For Carr AND Forearm Figs. G and H. Body erect. Extend fingers to utmost limit with strong tension. Rise on toes, slowly, as high as possible, closing the hands with the strongest tension. De- scend slowly to first position, again extending fingers to ut- most limit. 50 times. For THE UpPER ARMS Figs. J and J. Body erect. Lower the body by bowing the legs. Tense the arms and half-closed hands. Retain leg position while slowly lifting a very hevy imaginary object with arms only. Contract the biceps to fullest extent; hold a moment, relax, tense the arms again, push down very slowly as against great resistance, thus contracting the tri- ceps to the utmost. Retain leg position thruout. 7 times. For THE THIGHS Figs. K and L. Body erect. Lower body to deep-nee bend and rise immediately to first position. In descending, allow the heels to rise from floor, and close legs completely, lower thigh resting on upper calf. 25 times. Figs M and N. Body erect. Stedy the body by resting the hand on back of chair while lifting the right foot and kicking vigorously. Repeat with the left foot. 50 times each foot. 583Fig. 199. Illustrating the Warman System of exercizes described on page opposit. SatFor ABDOMEN, SHOULDERS AND Back (See Fig. 199, opposit) Figs. O and P. Swing arms up and back to first position, bending backward. Be sure to bend the nees. Swing upward and forward, extending arms abov, front and down, trying to touch the floor with the fingers, nuckles or palms. Do not bend the nees. Do not stop until move- ments ar completed. 50 times. For ABDOMEN, SHOULDERS AND Hips Figs. Q and R. Swing left arm (strongly tenst) out from side and up to highest point; the right arm (strongly tenst) pulling down to lowest point. Swing right arm up and left hand down in same man- ner, both arms strongly tenst. 25 times. Tue Liver SQUEEZER Figs. S and T. Twist body to right. keeping face to front, bringing left shoulder under chin, left arm across chest, right arm tense and extended close to body. Reverse by twisting body to left, face kept front, bring- ing right shoulder under chin as you cross the chest with right arms; left arm tense and extended close to body. Strike across the chest vigorously, but not violently. Do not move the feet. 15times. For CHEst, SHOULDERS AND BACK Figs. U and V. Body erect. Lower the body by bowing the legs. Extend arms at side on level with shoulders. Tense the arms and half-closed hands. Swing arms front and back, without lowering. Keep strong tension until completing the exercize. Do not sway the body. 25 times. Figs. W’ and X. Body erect. Lower the body by bowing the legs. Raise the arms at side. Tense them to the utmost when starting them outward and downward toward, but not quite to the body. Keep arms slightly bent at elbow. Relax the arms when raising them. 25 times. For Lecs, Lunes, Hart anp Liver Fig. Y. Stationary running. Hands to chest. Advance one foot. Transfer the weight from foot to foot—as in ac- tual running, except advancing. Begin with 100 steps. In- crease to 1,000. 585HELTH How to Get It; How to Keep It By One Who Has It By E. B. Warman, A.M., LL.D. Los Angeles, Calif. One may write never so fluently or talk never so glibly about helth and the advantages to be gaind by following a system of fysical exercizes while he, himself, never indulges in anything more strenuous than that involvd in the mere pushing of his pen. Every man should take his own medicin, provided it does not come out of a bottle. Where wil you find better medicin for the human body than that containd in fresh air, sunshine, deep breathing, proper bathing, and daily fysical exercizes? Let us take a retrospectiv view of only a few years and note the evolution of fysical training. At the time of my entering this field—forty-nine years ago—fysical training was largely a system of fysical straining. The, end or aim seemd to be the making of great muscles regardfess of helth. In the process of time the pendulum swung, as it always does in every reform, to the other extreme, and we had a system known as “fysical culture,” the end or aim being “grace.” It was highly suggestiv of a boneless creature, yet an im- provement on the over-production of muscle. Gracefulness is an essential element of ease as opposed to awkwardness, which is an undue expenditure of vital and nervous force. Therefore, so far as it goes, it is desirable, but it does not fil the bil. Recognizing the fact that there must be a golden mean between these two extremes, I cast about to find that which would meet the exigencies of the hour. After becoming familiar with about every system of exercizes extant, and not finding the ideal, I made bold to formulate one, choosing the best from the various systems and using a little original. ity on the side. From year to year I pruned the alredy too extensiv system, bringing it down to a thoroly practical basis 586and giving the maximum benefit with a minimum expenditure of time and energy. The next step was to find a name to fit the system not fully coverd by the terms, ‘“Fysical Training, or ‘“Fysical Culture.” For this I was obliged to coin that, which of recent years, has become wel nigh universal—Fysical Education. This term is all that it implies. By it I mean the educa- ting of the muscles of the body to hold the bony framework —the anatomical structure—as nature has intended, and as nature demands for helth. There is a fysiological law that unless the structure is right the functions cannot be right. Therefore, the correct poise of the body when sitting and standing, and the correct carriage of the body when walking form the very foundation and basic principle of helth, and should precede all helth exercizes, in order that there wil be no friction, no crowding of any organ of the body, no in- fringement, but that every organ may function on the helth plane. Keep the back of your neck against your collar. Do not let your backbone get too near your brestbone. Some persons by neglect hav become so stoop-shoulderd that if the hed wer turnd the other way they would be very ful chested. To carry your hed high is considerd fashionable; to carry your hart high is metaforical; but to carry your chest high is both desirable and helthful. Helth! What is it? Helth is wholeness. Therefore it is incorrect to speak of “il helth” or “bad helth,” or ‘“‘poor helth” or “tolerable helth, thank you.” There can be no modification of the term helth. No fruit can be, strictly speaking, partly whole, but it can be partly decayd. The body cannot be “partly whole” but it can be partly diseasd; hence, not whole. It is also an error to speak of “good helth.” All helth is good. Otherwise it is not helth. The word, “good,” is superfluous. To speak of “good helth” is to place it in the same category with other erroneous expressions such as “widow lady,” “funeral obsequies,” “wedding trousseau,” and “free gratis.” A good proof of our wholeness lies in the fact that we ar not cognizant of any organ of our body when they ar all functioning properly. If we ar whole no “disease” can affect us in consequence of our powers of resistance. We ar “germ” proof. Is that not “a consummation devoutly to be wisht?” 587Is it ever attaind? Yes, in many cases. How? By the strict adherence to the laws of helth? Who made those laws? They ar the immutable laws of God as exprest in nature. Violate a law of nature, ignorantly or otherwise, and you wil be obliged to pay the penalty in ful. “The laws of nature ar the laws of helth, and he who livs according to these laws is never sick. He who obeys the laws, maintains an equilib- rium in all parts, and thus insures true harmony; and har- mony is helth, while discord is dis-ease.” It has been truly said: “We ar not punisht for our fysical sins, but by them.” Conforming with those laws means right living. By right living, I mean daily fysical exercizes (as alredy given), fresh air and sunshine, deep breathing, the moderate eating of wholesome and nourishing food, daily bathing, etc. By right living you wil ad years to your life, and life to your years. Seek the sunshine. A gentleman living in this glorious climate of California had, at the time of the interview to which I refer, reacht the age of one hundred and twenty years, and did not appear over seventy. At last accounts he was stil going. When askt as to his prescription for longev- ity, he said, “There is no crankiness in my method. It’s simply giving the Lord’s own medicin a chance to do its work. I can assure you that one hour of bright sunshine, or sunlight pouring down on the bare human body is more ben- eficial than a whole dispensary of drugs.” The “old” gentleman livd on a ranch and never mist his daily exercize and sun bath. His grandson, eighty years of age (grandson, mind you) said that his grandfather could run a mile in six minutes on a sandy road. Here was a man who took his own medicin. A friend of mine recently past over the Great Divide at the age of one hundred and eighteen years. A week pre- vious to his “passing” he walkt four miles from his home and back again without resting. He, too, had the appear- ance of a wel-preservd man of seventy (wel preservd, not wel pickled). Here, also, was a man who took his own med- icin. I could giv you the names of scores of men, and some women, who hav past the hundred-mile post. In every in- stance they wer men and women who relied upon the benefi- cial effects of the fresh air, sunshine, moderate eating, etc. 588No glutton ever reacht the century mark. I cite these extra- ordinary cases as incentivs for you to join the race. These ar indeed exceptions; but they show “How far the gulf-stream of our youth may flow Into the Arctic region of our lives Where little else than life itself survives.” There ar just three life-essentials; just three things without which one cannot exist—air, water, food—and their relativ value is in the order named. One may go weeks with- out food, days without water, but only a few moments with- out air—oxygen. BREATHING FOR HELTH By ful, copious breathing (diafragmatic), we oxygen- ate the blood and oxydize the refuse. For many years I hav advocated exercizes that compel deep breathing, rather than the so-cald deep breathing exercizes—a distinction with a decided difference. When taking breathing exercizes (forst respiration), the over-distended air-cels occlude the blood vessels and force the blood back so that the oxygen cannot reach it and the imprisond gas cannot escape—thus causing dizziness which results from forst respiration. The desired end is obtaind only when both air and blood circulate freely in and thru the lungs. This is best accomplisht by some vig- orous fysical exercize. For all-round beneficial results, there is nothing to ex- cel brisk walking—up hil and down dale, keeping the mouth closed. Mountaineering makes the largest demand upon the nervous system; rowing, upon the respiratory organs; cyc- ling, upon the circulatory system. Running makes a demand upon all of these, more especially the hart. (“Deep breathing exercizes” for a sick person is a dif- ferent matter. We ar speaking of those who ar wel enuf to exercize. ) DrinkinG For HELTH Water is the only thing in the world that wil absolutely quench thirst. Raw water is an aquarium; boild water, a graveyard; mineral water, reumatism and premature old age; filierd water, a gay deceiver. Distild water, especially 589when double-distild and aerated, is perfectly free from all mineral and other deleterious matter. The drinking of dis- tild water, regularly, wil postpone the period of “senile decay” anywhere from ten to twenty years. Drink an abundance of water according to the needs of the system. If you perspire freely, supply the waste. A la- boring man seldom, if ever, has appendicitis. Why? In the first place, he hasn’t time; in the second place, he can’t afford it; in the third place, he drinks freely of water and perspires freely, thus eliminating the waste products. Constipation is usually the forerunner of appendicitis. Bile is the natural purgativ of the body. To diminish the amount of water the body needs is to diminish the amount of bile. TEA AND COFFEE Tea is an intellectual drink—a brain stimulant having no reaction when properly brewd. Theine, the most essen- tial element, is almost as quickly soluble in hot water as is sugar. To prolong the brewing beyond three minutes has a deleterious effect on the human system. Coffee—the blessed beverage—"“the cup that cheers but does not inebriate’’—is a “nectar for the gods.” It can be, and has been scientifically proved that coffee, when properly made by percolator or French drip, is a non-reactiv stimu- lant. It should be taken without trimmings. The cream in the coffee works a hardship on both stomac and liver. The activ principle is caffeine (over which a great hullabaloo has been made) which, when drank in moderation, is not a nerv destroyer but a nerv restorer. But tea, overdrawn, and coffee boild ar poisons. Tea and coffee drinkers ar not, necessarily, tea and cof- fee drunkards. Eating ror Hettu There ar those who undereat, but they ar in the minor- ity. Overeating is undoubtedly the cause of many, if not all of the ils of suffering humanity. To say, “‘All the ils which flesh is heir to,” is an erroneous statement. Flesh is not heir to any ils. Helth is ours by divine heritage. ‘oods ar divided into classes. The proteids ar the flesh-formers; the carbohydrates (starches and sweets) ar the work-foods; the fats ar the heat-foods. These should be properly proportiond according to one’s needs. But abov 590all else, the selection of food should be such as to contain the various mineral salts of which the human body is com- posed. These, to be fully assimilable, must be in their nat- urally organized state, as found in grains, fruit, vegetables, etc. Normally, one can take care of anything wholesome, if there is not an overproduction or a wrong combination. Of these you can familiarize yourself by the study of food values. But you would be better off without this knowledge, if it leads you to become self-centerd, and causes you to analyze every mouthful of food you eat. Some food cranks and food faddists know so much about diet, and ar so en- slaved that they ar ever i] at ease when invited out to take “a square meal” lest they break from their usual routine. When eating for helth, ever bear in mind that no one can hav helth who habitually eats too much, or eats too often, or eats too many kinds of food at the same meal, or eats when hurried, anxious, or excited; or when rising late, gulps down a harty breakfast and sprints for the car; or Junches at a “‘minute-lunch-counter” to “‘save time.” Wuen To Eat Man is the only animal that wil eat when il. Man is the only animal that eats by the clock. You should eat when hungry, provided it is true hunger—not mere appetite. A hungry man is never a “kicker.” He wil eat of whatsoever is set,before him, asking ‘‘no questions for conscience sake.” Two meals a day should suffice for the average man or woman—a very light breakfast and a harty six o'clock din- ner. After years of experimenting, I find this plan prefer- able, for mine and me, to the “‘no-breakfast” theory. Do not eat when tired—tired in brain or body; but in- sted, relax, let go, if only for fifteen minutes—better fifteen minutes now than fifteen weeks or months later on. Do not eat when you hav a grouch. Throw it in the waste basket before leaving the offis—the janitor wil take care of it. Or if you ar so unfortunate as to take it home with you, giv it to the dog and then shoot the dog. How To Eat Thoroly masticate every mouthful—not to the extreme, as in “Fletcherizing;’’ nor counting the number of chews (no 591mental arithmetic at the table), but “get the habit” of near liquefying all food. The mouth has work to do which the stomac cannot do. Be cheerful when at the table. A sour contenance may cause a sour stomac. Whatever you eat, do not fear it. If you fear it, do not eat it, but if you eat it, do not fear it. Don’t wonder if what you hav eaten wil agree with you. It wil not if you wonder. Say goodby to it, never expecting to hear from it again. Wuar to Ear I would first draw the line on that which is not nutri- tious. Do not tickle the palate at expense of the stomac. Whether your food comes from the animal or the vegetable kingdom, one rule holds good—there should be a propor- tionate amount of the proteids, carbohydrates and fats, to- gether with the necessary organic salts. Some persons ar satisfied in the matter of eating if they only “get ful”—no matter with what. You should choose quality rather than quantity. If you eat sixteen ounces of beans you get twelv ounces of nourishment. To receive the same amount of nourishment from cabbage, you would be obliged to eat fifteen pounds. However, as to the mineral salts (vitamins), the cabbage contains four times as much as do the beans. Do not eat unpalatable food “because it is good for you.” It is not good for you if unpalatable, as the gastric Juice wil not flow for food you do not relish. It is said, and believd by many, that vegetarians ar calm, mild and peaceful; that flesh eaters ar inclined to brutality and hav greater animal propensities. Proof of this is wanting. It is not so much the kind of food which goes into the human being as the kind of human being into which the food goes. Whatever else you do as regards helth, it is of the utmost importance that you keep the four eliminating agents of the body—lungs kidneys, skin, and bowels—normally activ, that is, without resorting to drastic remedies. 592BATHING For HELTH To hay helth—a system wel toned, a clear complex- tion—you should take some kind of a bath not fewer than three hundred and sixty-five times a year. The kind of bath depends on fysical condition, one’s environment, and actual needs of the body. I would recom- mend a cold water tub bath for those who have “vitality plus’’"—vitality enuf for immediate and helthful reaction. To take a hot bath, other than as a remedial agent, is more harmful than helpful—a nervous leakage; whereas a warm bath, or a tepid bath acts as a sedativ and cannot be too highly recommended. CoLor oF CLOTHING FoR HELTH The salutary influence of solar heat and solar light, especially the latter, ar not sufficiently wel-known to hav their therapeutic value appreciated. As a rule, avoid black clothing when exposed to the rays of the sun. Black absorbs the light of the sun but transmits the heat. White or light-colord clothing transmits the light of the sun and reflects the heat. It is the Jight of the sun that the human body needs. The relativ effect of the various colors of clothing produced upon the human body when exposed to the sun is as fol- lows: White 100° F., pale straw 102°, dark yellow 140°, light green 155°, dark green 165°, turkey red 168°, light blue 198°, black 208°. It wil be seen that white produces the east percentage of heat and black the largest. Tue Span oF Lire The natural term of man’s life, arguing from the logic and evidence of comparatiy zodlogy, is one hundred and forty years. The animals in their natural state live to an age equivalent to five times their period of growth. In this respect man should be no exception. Scientists, as a rule, agree that man’s growth is not attaind until his twenty- eighth year. Hence, applying the principle to man givs him five times twenty-eight, or one hundred and forty years to sojourn here—better say, one hundred and forty and then some. It is not wise to place a limit on life. 593As one who takes his own medicin; as one who lives up to the principles advocated, I hav no hesitancy i in saying that I think I hav a lease on life for one hundred and forty years, with the privilege of extending the lease if I desire. Conclusion Just a word in conclusion—a word to enthuse some fellow-traveler along the way. If you want to go bounding past the hundred-mile post with a hop, skip and a jump, you should never talk of “growing old” for in so doing you ar sowing age-producing seeds in your subjectiv mind, in consequence of which you wil reap old age conditions in every part of your body. Insted of saying, “the older I grow,” say “the longer I liv.” You'll liv longer if you do. This is the picture I would present to you: From sixty-five to seventy we ar on the last stretch of Youth. At seventy we enter the vestibule of Middle Life, there to re- main until ninety-five, at which time we enter the vestibule of “Old Age” (so-cald). At one hundred, we enter the “old-age” room there to remain as long as we like. We should begin the second century stronger than we began the first. The soul of man does not age with the years. Every day I make the following affirmation: and Strength; Helth and Strength to every part of my body; that every organ of my body shal function on the helth plane. Age, with its infirmities, cannot touch me; youth cannot leave me; the spirit of youth shal ever abide with me. With Victor Hugo I can say: “The snows of winter ar on my hed, but eternal spring is in my hart. When I go down to the grave, I can say, like many others, I hav finisht my day’s work but I cannot say, I hav finisht my life. My day's work wil begin again the next morning. The tomb is not a blind alley; it is a thorofare. It closes on the twi- light; it opens on the dawn.” Vigeroultouns Br BW eran 504HEAT, COLD, HYDROTHERAPY, AND BATHS Heat Heat used therapeutically is either radiant or convectiv —light heat or dark heat. The one is a rate and mode of motion occurring in luminiferous ether. The other is heat conveyd thru some non-luminous substance. Radiant heat shines. Convectiv heat is an interchange of temperatures, and is dissipated when the surrounding objects ar of equal temperature. Light or radiant heat is far more penetrating than dark or convectiv heat. Besides, with light or radiant heat we get the value of the light. Dark heat rays can hardly pass thru glass. Dark heat applied in compresses and fomentations and hot water bags, etc., heat only the surface. It dilates the capillaries and reduces congestion. Light heat raises the temperature of the body, relieves stasis, and augments elimination. It rectifies faulty metabolism. Cotp Cold can be used therapeutically, but to a limited ex- tent. The general effect of cold is depressing. It contracts the capillaries and thus aggravates congestion. Cold can be used only on patients who react wel. If ever in doubt as to which to use, whether Heat or Cold, use Heat. Cold appli- cations for a brief period stimulate circulation in some per- sons, but in others any cold application is depressing. Use Heat more, use Cold less. HyDROTHERAPY Hydrotherapy covers a large field. By grasping the different effects of heat and cold, and realizing that many patients cannot endure cold water, we ar on the right track to use Hydrotherapy. Most offises ar not equipt for using water baths. For home use, the needle-spray shower, such as can be attacht to any bath tub, is to be recommended. Shower baths within cloth curtains ar not agreeable to the majority. A hot shower or tub bath followd by a cold needle- spray-shower bath, is good for some neurotic conditions; but many physicians hav had their patients go to some other doctor, because they recommended cold baths. Cold baths, if tolerated at all, should be taken in the morning as soon 595as one rises. Hot baths, if not too prolongd, ar sedativ at night and with some aid in producing sleep. Any baths for therapeutic effects should be immediately discontinued if they make the patient worse. BaTus Baths for therapeutic purposes ar of various kinds, but the electric light bath seems to be most perfect. The phy- sician can hay an electric bath cabinet as one of his aids, and the application is easy, practical and beneficial. We get the effects of the light as wel as of the heat. There is as much difference between the “light bath” and the “dark bath” as between the light heat and dark heat. The light bath is penetrating. It dilates the capillaries, reduces con- gestion, stimulates the hart, quickens elimination. Besides this, the light penetrates every cel in the body. SUMMARY Altho these four modalities ar of great therapeutic value, yet in this work I shal not say very much about them under this special hed. Much is said regarding radiant heat in the lecture on Radiant Light and Its Therapeutics. From my standpoint cold has not very much of a place in therapeutics. Hydrotherapy covers such a large field that only just a few words can be said about it in such a work as this. Besides hydrotherapy is not practical for the ordinary offis specialist. It is suitable only for sanitaria. Under the hed of Exercizes, and especially under the hed of Exercizes for the Physician, etc., is mentiond some practical points regarding baths. The electric light bath I think is the best of all baths, and that is mentiond in the lecture on Electric Light Baths.Part Four. Lecrvure III. PRACTICAL TREATIS ON MEDICAL MASSAGE Many do not use the powerful incandescent lamp radia- tions in connection with massage, but from my experience in both methods of massage, I am sure that radiations from the powerful incandescent lamp aid greatly in relaxing the tissues and thereby enhancing the beneficial effects of mas- sage. METHOD OF APPLICATION According to the reports of many fysical therapeutists who ar using soluble stainless iodin in conjunction with massage, it seems as tho radiations from the powerful in- candescent lamp ar a great adjunct in this work. The soluble iodin, preferably Jodex, is to be applied to the diseased parts, which should be gently rubd or mas- saged until the color entirely disappears. While the massaging is being done, or for a few min- utes before, radiations from the 2,000-candle-power or 3,000-candle-power lamp ar allowd to fall on the parts that ar anointed with the soluble iodin preparation. This greatly enhances absorption and is doubtless superior to hot fomentations or baking. The radiations from the 2,000 or 3,000-candle-power incandescent lamp not only aid in the absorption of the soluble iodin but relieve pressure within the tissues and thereby greatly aid recovery. As I hav had so much success with massage in con- junction with the 3,000-candle-power incandescent lamp and soluble iodin (especially Ung. Iodi, M & J), I wanted my readers to know about it. In order that I might hav the very latest and best authority on the subject, I requested the editor of the Pharmacal Advance to giv me a concise and practical treatis on medical massage, especially in connection with soluble iodin. 597Inasmuch as massage is little by little getting away from the medical profession, where it really belongs, I know my readers wil be pleasd to hav this subject presented in the following concise and practical manner. History or Massacre History informs us that massage has been practist from the most ancient times amongst savage and civilized nations, in some form of rubbing, neading, anointing, per- cussion, passiv or mixt movements. From the days of Homer down to the present time, we find eminent physicians, filosofers, poets and historians, who record their apprecia- tion of massage. DEFINITION OF MAssaGE The word massage means—neading, manipulating, rolling, and percussion of the external tissues in a variety of ways, either with a curativ, palliativ or hygienic object in view, and it is the scientific manual application of certain movements adapted to diseasd conditions of the human body. Mobe oF PRoceDURE Among those familiar with massage, opinions differ somewhat as to the exact mode and manner of procedure which should be followd by a good masseur. Some ar of the opinion that the skin should be first pincht, and that the deep parts should be reacht subsequently, that the action should be rapid, jerky and quick. The writer, who for many years past has been an activ practitioner of massage, is entirely opposed to this mode of procedure. If, for in- stance, a painful joint is to be delt with, it should first be extended, after which the joint should be firmly and stedily manipulated. If the abdomen is to be massaged, the thighs should be partly flext, and deep but very carefully graduated pres- sure should be maintaind thruout the entire operation. After the deep parts hav been so manipulated, then the superficial structures should be firmly gript and squeezd, and even neaded and pincht (See Fig. 200). 598PROCEDURES IN MASSAGE (See Fig. 200.) All the various useful procedures in massage may be classified under three heds, as follows: 1. Effleurage; 2, Petrissage; 3. Tapotement. Under each of these heds we hav several subdivisions, which wil be separately treated in their proper order. First ProcepurE: EFFLEURAGE All stroking movements used or applied in perform. ing massage come under this heding. Effleurage is subdivisible into two important parts, namely: STROKING and FRICTION. Srrokine: The first subduple of effleurage, is usually indicated in conditions of pronounst inflammation, indiges- tion, constipation, etc. Procedure: Passiv stroking is given in the direction of the arterial blood current, downward or outward from the hart, and should never be given to and fro, but in one direction only. It may be given with the palms of one or both hands or with the cushions of the fingers or thums. Effect: 1. The superficial circulation is improved. 2. Cutaneous nervs ar soothd by light stroking. 3. Firm strok- ing causes dilation of the superficial vessels, so raising the local temperature. 4. Passiv stroking increases glandular activity. FRICTION, the second subduple of effleurage is usually indicated in sprains, dislocations, fractures, inflamed joints, ete. Procedure: Friction is given in the direction of the venous blood current. It may be given with the heel of the hand, thum or the fingers. To giv friction properly, make small successiv circles over the part requiring treatment without moving the skin. When the part is not painful con- siderable pressure may be exerted. Effect: If friction is applied to the parts above an inflamed condition it wil relax congestion by drawing or forcing the blood away from the diseasd area. Thus absorp- tion is enhanst and inflammation reduced. SECOND PROCEDURE: PETRISSAGE All pressure movements used or applied in performing massage come under this hedding. 599PerRIssAGE, is subdivisible into two important parts, namely; SUPERFICIAL NEADING and MANIPULATIV NEAP ING. SUPERFICIAL NEADING, the first subduple of petrissage is usually indicated in conditions of stifness, pregnancy, reu- matic gout, hemorroids, neuritis, etc. Procedure: Superficial neading is given from abov downward in the direction of the arterial blood current and in one direction only. It may be given by grasping a group of muscles between the fingers and thums of both hands, the thums on one side and the fingers on the other. The thums ar held stedy so that the muscular mass in hand can be workt back against them with the fingers. Effects: 1. Nervs and muscles ar stimulated. 2. Lym- fatic and venous circulations ar accelerated. 3. A larger supply of arterial blood is brot to the parts massaged. 4. Glandular activity is promoted. 5. Elimination and absorp- tion ar increast. 6. E-ffusions and swellings ar reduced. 7. Tissue growth is stimulated. MANIPULATIY NEADING, is the second subduple of petrissage and is usually indicated in conditions of paralysis, locomotor ataxia, anemia, obesity, reumatism, sciatica, reu- matoid arthritis, muscular reumatism, etc. Procedure: Manipulativ neading, like superficial nead- ing, is given in the direction of the arterial blood current. It may be given by grasping the muscles in the hand between the fingers and the heel of the hand, and by the assistance of the ball of the thum, the muscles in hand ar to be squeezd, rold or neaded by the entire heel of the hand against the fingers. Especial care should be exercized in not allowing the hand to move on the skin. Effect: 1. Development of the muscles is promoted. 2. Adhesions ar broken down. 3. The absorption is en- hanst. 4. Venous congestion is relievd. 5. Thickening and shortening of the muscles ar prevented. Turrp Procepure: TAPOTEMENT All percussiv movements used or applied in perform- ing massage come under this hedding. Taporem is subdivisible into two important parts, cussion and VIBRATION. 600 namely: PE:PERCUSSION, the first subduple of tapotement is indi- cated in all forms of muscular weakness and atrofy, and wherever stimulating effects ar desired. Procedure: Percussion is given with the ulnar edge of the hand, the palm of the hand, the tips of the fingers or the closed hand, and is known according to the method em- ployd, as ulnar, palmar, digital or fistic percussion. It is usually administerd by the two hands which ar used in alter- nation. The movement should be from the rist joint so as to giv the blow the required quality of elasticity. Suggestions: Ulnar percussion is usually applied to the back. Simultaneous palmar percussion is usually applied to the extremities. Fistic percussion is usually applied to the thighs,—to the gluteal muscles. Digital percussion is usually applied to the hed. Effect: 1. Nerv centres ar stimulated. 2. Strong and prolongd percussion causes a benuming effect upon the part being massaged. 3. Moderate percussion causes contrac- tion of the blood vessels while prolongd percussion dilates them. 4. Moderate percussion increases the irritability of the nervs while prolongd percussion temporarily paralyzes them. ViBRATION: The second subduple of tapotement is performd by the aid of mecanical vibratory machines. We wil not therefore take up this modality for the present, rather confine ourselves to the manual. MepicaL MassaGe While the various forms of curativ massage hav been firmly gaining in favor with the medical profession and the general public for many years past, it is a fact that medical massage has not been very much practist until re- cently. The reason for this seems to be that effectiv reme- dial agents without objectionable features wer heretofore unknown. Topic MAssaGe For the past four years, however, iodic massage has become very popular with many physicians, owing to an available form of iodin without any of its inherent draw- backs. olThe Remedial Agent “Iodex” (Ung. Iodi M. & J.) is an ideal iodin preparation for external application which is free from all irritating, corrosiv and staining tendency. It is an efficient and a powerful absorbent. Jodex, which is a scientific product and which represents the zenith of far- maceutical achievements, solvs the whole difficulty of effec- tiv medical massage and opens an avenue to a new method of procedure to physicians in the treatment of cases hitherto intolerant. Method of Application: lodex is to be applied to the diseasd parts which should be gently rubd or massaged until the color entirely disappears. In some conditions—which wil at once suggest themselvs to the medical mind—hot fomentations ar of assistance to enhance absorption, in others cataforesis or baking. Probably the latest and best tecnic is to supply radiations from a powerful incandescent lamp, or a smaller lamp, if necessary. Effect: The chief caracteristic feature of iodic mas- sage is the relief which it affords pain: its analgesic and soothing influence enable the practitioner to gently massage a sore joint without producing pain. Procedure: The method of procedure is to apply Iodex abundantly to the diseasd parts and rub it in thoroly with a gentle stroking movement: after the color has all disappeard superficial and manipulativ neading massage should be ad- ministerd. After the pain in the diseasd parts is lessend to such an extent that the patient can endure it, percussiv mas- sage should be applied as rapidly as possible, and continued for from 5 to 20 minutes. Sciatica: Severe attacks of sciatica wil redily yield to the influence of iodic massage and powerful, radiant light. Locomotor Ataxia wil be greatly benefited by a course of iodic massage, a markt improvement in the tone of the muscles wil be observd after even the first treatment. If iodic massage is frequently given the patient, improvement wil also manifest itself in the disturbances of sensibility, paresthesia, and anesthesia wil disappear. Lumbago: As in other reumatic soreness, iodic mas- sage wil afford to the physician a method of relief for his patient. The application of manipulativ neading in cases of this kind results in the disappearance of all soreness and relaxation of the crampt muscles. 2Reumatoid Arthritis, reumatic gout, or when arthritis deformans assumes a cronic form after an acute attack, and when the disease has affected every joint and apparently has run its course, and seemingly done its worst, rapid improve- ment with permanent amelioration of symptoms wil be se- cured by the application of iodic massage. Even when there is eburnation of the articular surface and rattling of the bones, with distortions of the joints, iodic massage wil giv results far beyond the expectations of any physician. Todic Massage is indicated in reumatism, myositis, ele- fantiasis, muscular rupture, edema. The symptoms of dis- eases such as these usually occurring in reumatics and in those who suffer more or less from reumatism, occasiond perhaps by excessiv fatigue, sudden or violent strain, injury or colds, invariably abate and quickly disappear in a very satisfactory manner under treatment with iodic massage. Procedure: The method of procedure in diseases of this kind is to apply Iodex generously to the diseasd parts and rub it in with a gentle stroking movement til all color has disappeard, then massage with a deep manipulating neading movement over the affected group of muscles. Per- cussiv massage, together with vibration, may be applied firmly over muscular masses where there is a condition of myositis, muscular rupture or elefantiasis. Sprains and severe inflammatory conditions in general wil redily yield to iodic massage; the pain and swelling wil abate under its influence. Synovitis: The use of cold applications in sprains or synovitis ar not without danger for the reason that they may cause gangrene. Aside from this, by the suspension of nutritiv action, which they sometimes cause, the process of repair may be retarded. Procedure: The method of procedure in troubles of this kind is to apply Iodex liberally to the diseasd parts and rub it in with a gentle stroking movement til all color dis- appears, then massage with rotary friction, superficial and manipulativ neading. Use powerful radiations of light from an incandescent lamp, or some other lamp, whenever it is possible in con- nection with iodic massage.Fig. 200. Massage Tecnic A, B, C, and D, represent efileurage; A, B, and C, represent stroking while D, represents friction. FE, and F, represent petrissage; E, representing deep or manipulativ neading where the movements should pro- cede toward the center of the body; and F, representing thum or superficial neading, which should advance toward the extremities of the body. G, and H, represent tapotement; G, representing hack- ing or percussion given with the ulnar edge of the hand; H, representing palmar slapping or clapping of the back. No- tis that the fingers ar closed in such a manner as to form an air cushion between the hand and the body. This clap- ping of the hands should be done first with one hand and then with the other. 604VIBRATO-MASSAGE Nearly all fysical therapeutists ar familiar with various kinds of tissue oscillators or, as some call them, “body shakers.” Many of them ar very crude while some ar very complicated. I hav had some experience in devizing apparatus for mecanical massage or body oscillation. I hav devized special mecanical apparatus for vibrating the feet, as I found it of great benefit in treating conditions of cold feet, num feet, tickling and burning feet, etc. For tired feet, probably os- cillation is the quickest and best remedy. Fig. 201 illustrates the “Vibrato-Masseur” manufactured by the Vi- brato-Masseur Co, Minneapolis, Minn. The cabinet is 42” high, occupi floor space 18”x 30”; and a similar space in front is required for the fone using it. The wood work can be made to match offis fixtures. All mecanical parts ar in one unit fastend on an iron bed plate and containd in a hard wood case mounted on four-leg standards, The movable metal parts and trimmings ar hevily nickeld, The other parts ar enameld. Motor is furnisht for D.C or A.C, Electric connection can be made to an ordinary electric-light fixture so apparatus can be placed in any desired location. ‘The stroke regulation is affected by turning the “key” on the top near the front edge. A represents the extension for foot vibration. B represents the terminals to which the various applicators can be attacht. Fig. 201 shows the “Vibrato-Masseur.” This appara- tus imprest me the first time I saw it but it lackt an attach- ment for foot vibration. I immediately took it up with the manufacturers and askt for an attachment for vibrating the feet. They hav complied and the attachment is shown in Fig. 201, A. 605Tissuz OscILLATION Tissue oscillation is always indicated where massage and vibration effects ar desired—in ailments directly trace- able to lack of blood supply due to poor and unequal circu- lation; to dispel congestion; stimulate activity; assist in cor- rection of improper functioning of parts and organs; strengthen muscles; break up adhesions; relax tension of muscular structure; bild up weak and undevelopt parts; etc. No less prominent and successful is the feature of passiv exercizes for convalescents, injured and deformd people, and those who do not take the activ personal meth- ods which provide a means for systematic body treatments for general tonic effects. No passiv exercize is more convenient or practical and so far-reaching. s of belts he harder Fig. 202. Showing the Vibrato-Masseur in use. Many s and applicators can be used to suit the patient's requirements. the patient pushes the deeper is the effect. One of the special features of tissue massage is the treatment of obesity or the reduction of fat. It does away with the tedious personal efforts of hand massage methods. Some of the special features of the Vibrato-Masseur here illustrated is that the stroke can be varied thru a lati- tude of 14 to 2 inches during operation. It produces the effect of vibration, massage, oscilla- tion, and passiv exercize all at one time. The motor is large, thus insuring ample power and dependable servis; is slow running, which permits the flesh to follow the movements. The machine action is indirectly communicated to the body thru the medium of a belt used as an applicator, Fig. 202. The use of belts allows introduction of distinctiv kinds 606for different purposes. The belts ar flexible and movable and conform to the person, and ar adjustable to any part. Depth and nature of treatment is establisht by selection of the appropriate applicator, amount of pressure exerted against it, proper adjustment to part, suitable stroke regu- lation, and time used. The action is confined solely to the patient—the machine does it all. The selection of applicators is very complete, including corrugated stitcht belts, soft applicator of stout web material for treatment of delicate structures and especially for using over parts where there is not much flesh as wel as over Jame and sore parts; also roller applicators composed of a series of rollers or spools arranged in belt form for use in the reducing of obesity and for hardening of muscles. Tue Use or THE VIBRATOR In VipraTo-MassaGE A good, strong vibrator can be used for doing vibrato- massage. As there ar so many different kinds of vibrators on the market, it would be useless for me to try to explain them or go into their different points of excellence. Many of the electrical devices hav a vibrating attachment with them. Fig. 203 is the style of vibrator that I use. I hav found it a very strong and dependable outfit. Mine is attacht to a cabinet rather than a pedestal so that all the different attachments can be kept in the drawers and no more floor space occupied than with the pedestal. A small, weak vibrator is not of much use for vibrato- massage. 07Fig. 203, The Victor Vibrator, manufactured by The Victor Electric Corporation, Chicago, Ill. This vibrator I hay used for years and hav found it very dependable. It can be used for Vibrato-Massage as wel as for regular vibration treatments.A NEW FOLDING TREATMENT TABLE Figs. 204, 205 and 206 show a new folding treatment table made for me by a Los Angeles cabinet maker. Notis that the braces ar of steel and so made that they wil stand great strain and weight. The wood is quarterd oak of natural finish and the top is coverd with lether or imitation lether. From the illustrations any good cabinet maker could duplicate it, but would hav to hav the steel braces made up by a blacksmith. Fig. 205 shows how they fold up. The height of the table is 2934”, the width is 2214”, and the Fig. 204. A new folding, treatment table made by a Los Angeles cabinet maker for the author. It is very strong and convenient for all forms of fysical therapy. length of each section is 36”, making the table six feet long over all. If a light-weight table of this style should be desired, so it could be easily carried to the patient’s house, the wood could be of pine, whitewood, or some other soft, light wood. 09Fig. 205. Table shown in Fig. 204 partly folded up. olFig. 206. The folding table shown in Figs. 204 and 205 closed up like a dress-suit case and redy for carrying, Such a table is very convenient to hav in one’s offis, as it can be put away and used when “a rush” comes oulPart Four. Lecrure IV, ELECTROTHERAPY Four forms of electricity ar used therapeutically : (1) The Galvanic, constant, or continuous current. (2) The Faradic, induced, induction, or interrupted current. (3) Static, frictional, tension, or Franklinic elec- tricity. (4) High frequency, or oscillating electricity. No one should attempt to use electricity therapeutically without first lerning some of the fysics that apply to it. In using the Galvanic current, battery cels wer formerly em- ployd, and ar now by many; but where one can get the “street current” as a direct current, it is almost always employd. If the current is alternating, a motor generator is used and the direct or constant current taken from it. In using constant, direct, or galvanic current, a few funda- mental points regarding the properties of the two poles must be borne in mind. If the two poles ar put into water, oxygen gathers at the positiv pole and hydrogen at the negativ pole. From this we see that the positiv pole is acid-producing and the negativ pole is alkalin-producing. The positiv pole is hemostatic, sedativ and vaso-con- strictor, while the negativ pole is the opposit. The positiv pole hardens tissue, while the negativ pole softens tissue. The positiv pole produces an acid caustic and a hard un- yielding cicatrix, while the negativ pole produces an alkalin caustic and a soft, yielding cicatrix. The positiv pole wil harden and aggravate a stricture while the negativ pole wil soften and dilate a stricture. Never use the galvanic or direct current without pass- ing it thru a milliampéremeter. Know how much current you require for the treatment and be sure to watch the meter. We ar all supposed to know Ohm’s law, “The strength of the current passing thru any part of a circuit varies directly 612as the difference of potential between its elements and in- versely as the resistance of the circuit itself.” In other words, if C equals the current in ampéres and E represents the electro-motiv force, or voltage, and R the ohms of re- sistance in the circuit, we would hav as a formula, C=} With the direct or constant current we produce elec- trolysis or the breaking up of a substance into its ions. The removal of hairs, warts, moles, etc., is accomplisht by electrolysis. Fig. 207. McIntosh Universalmode, manufactured by McIntosh Battery & Optical Co., Chicago. Cataforesis is an electrolytic process whereby the ions ar carried into the tissues. This is a most important branch in Electrical Therapeutics. Fig. 207 illustrates the McIntosh Universalmode. This is one of the electrical outfits that I use and can recom- mend _very highly. Fig. 208 illustrates the modalities of the Universal- mode. Fig. 209 shows the No. 4 McIntosh Polysine Genera- tor. This is also a most excellent electrical outfit. 613Fig. 210 illustrates the modalities obtaind from this Polysine Generator. There ar many other electrical outfits and wall plates on the market but as so many of them ar useless, I would ISISISSISISSSSSIS T Combined Galvanicand Faradic e AVAVAVAVAVAVAVAN ‘Sinusoidal 1800 Periods Per Minute ° S3.Rapid Sinuseidal 1800 Cycles Per Minute NS U _ U 4, PrimaryFaradve o 5 Secomtary Faradic ° S catvante . © Pinterrapted Galvante Ste 88 Titerruptions Per Wienute & Dragmastie Lamy 9 Cautery. - ° NN Nr 10Combined Galvanic and Faradic Wave 3to88 CyctesFer Min ° 11 SupertmposedWave 3088 CyclesPer Minute ° 12 Surging Stmusoidal. 610178 Periods Per Minute ° 13, Primary FaradicWave $toas Cycles Per Minute. ° 1a. SecondaryFaradic Wave Sto 88 Cyclea Per Minute ° 15, Slow Sirusoidal. 3108 Cycles Per Minute oN 16 Interrupted Galvanic Wave 31288 Interruptions Per Minute Fig. 208, Modalities of the Universalmode. caution every buyer of an electrical outfit claiming to giv sinusoidal currents, because many of them do not giv the kind of current that is required for sinusoidal stimulation. 614There ar, however, several good makes of apparatuses on the market, but as I hav not had experience with them I am not illustrating them here. The Sinusoidal current is an alternating, galvanic cur- rent in which the potential rises gradually from zero to a maximum point abov an imaginary base line and then gradually returns to zero and to a like distance below the same base line. Physicians employing spinal therapeutics could hardly carry on their work without this modality. In using sinusoidal current, one should al s realize just what he wants—stimulation or sedation. The slow-sine wave produces stimulation, if slow enuf to allow the muscles Fig. 209. McIntosh No, 4 Polysine Generator, interchangeable on A.C. and D.C, shown in vertical position as wall plate. acted upon to come back to rest before the succeding stimu- lus is applied. The uninterrupted rapid-sine wave should be used only for sedation or relaxation. It can also be employd for reducing fat. The Surging Sinusoidal or Combined Sine Wave is a form of sine wave produced by passing the rapid sinusoidal current thru a rotor, thus producing a slow-sine wave made up of the rapid-sine current. (Fig. 208.) This modality is especially indicated when stimulating large muscles. It should never be used more than two or three minutes at a time if one wishes stimulation, because 6151. oO. 2 0 3. Q 4 oO 5. 6. ig. 210. Shows diagrammatically the modes given by the No. 4 Polysine Generator. No. 1 Rapid sinusoidal, 1200—3600 cycles a minute. No. 2 Slow sinusoidal, 10—120 cycles a minute. No. 3. Surging sinusoidal, 10—120 cycles a minute. This modality is obtaind by passing the rapid-sine current thru a rotor, thus producing a combined sine wave. No. 4 Superimposed wave, 10—120 cycles a minute. This modality consists of the combined galvanic and sinusoidal current past thru the rotor together. No. 6 Slow surging galvanic, 10—120 periods a minute. This current has practically the same sensation’ as the slow sinusoidal, but the contrac- tion can be concentrated at one pole. Often of value in different forms of paralysis. It contains the chemical action of the galvanic with the stimulation of the slow sinusoidal. Note: The No. 4 Polysine Generator also givs the Galvanic Current as wel as a control for a Diagnostic Lamp. 616the rapid-sine current, of which this wave is made, has a relaxing effect upon the muscles if not interrupted. The Superimposed Wave is a galvanic current and rapid-sine wave combined and past thru a rotor. (Fig. 208.) It is a tonic and stimulating modality and should never be used more than a minute or two at a time when used for its stimulating effects. The Combined Sinusoidal and Galvanic Modality is made up of the rapid-sine current and the galvanic current without passing it thru a rotor. That is, it has the dis- tinctiv polar effects of galvanism. (Fig. 208.) This modality can be used occasionally for special pur- poses. Notis If one uses an apparatus with a current selector of a convenient dial type, I hav found it advantageous to change from one modality to another during a treatment. For ex- ample, one may use the slow sinusoidal modality for 7 min- utes, the surging sinusoidal for 2 minutes and the super- imposed wave for 1 minute, being particular to always turn the current entirely off from the patient before changing the modalities. By giving the different modalitics during one treat- ment, we hay a varied exercize for the different muscles; and I find I get a better effect than to use one modality stedily during the whole treatment. Never use sinusoidalization for more than 10 minutes at a time. The Faradic current is a rapidly alternating induced current possessing no polarity. There is a wide difference between a rapidly interrupted galvanic, or direct current, and a faradic current. The faradic current is more mecani- cal than medicinal. It stimulates by rapidly massaging the tissues. Therefore it is tonic and aids metabolism. Its efficiency in reducing fat can thus be explaind. The sinu- soidal current is fast taking the place of the faradic current in therapeutics. It is smoother and more easily controld. Static Electricity is frictional electricity. Its voltage is enormous but its amperage is nil. It requires about 50,000 volts of pressure or “push” to force a current across a spark gap of one inch. 617The static mode is vibratory in caracter, but as the oscillations run into the millions a second, the different lengths of waves must be legion. As the nervs of the body ar of various lengths and tensions and as all live nervs ar in a state of vibration, we can redily understand why the static modality is so beneficial to tired or diseasd nervs. Each nerv is supposed to take up its own wave length from the static vibrations the same as one tuning fork wil vibrate when its duplicate is set into vibration. The different mo- dalities that can be employd from the static machine make this form of electricity of great therapeutic value. Fig. 211. The author's special Static Electricity Generator and High Frequency outfit. This shows the author's original static spark regulator. (Nearly all forms of vacuum tubes, including the x-ray tube, can, with suitable interrupters, be excited with the static machine. ) Static modalities vibrate or massage the body from the smallest cel to the largest muscle. They really giv cellular or tissue massage and relieve stasis, thereby helping to re- store the polarity of the organism. (Fig. 211 shows my special Static and High Frequency outfit.) 618,The Sinusoidal current along with the radiations from the powerful incandescent lamp wil do all that static elec- tricity or high frequency currents can do. High Frequency electricity is oscillating electricity from a condenser or static machine. All forms of high frequency currents ar disruptiv discharges. Condensers can be charged from a static machine or from a coil. The discharges from the former ar smoother and less irritating than from the latter. Special interrupters can be used in connection with Fig. 21a, This illustration shows the Hogan Silent Roentgen Trans- former. This apparatus also contains a high frequency outfit. It is interrupterless, motorless, commutatorless, and noiseless; has a protectiv ed-lined door extended, serving as screen to the operator who, standing behind it, can manipulate all of the various controlling devices in perfect safety from exposure to the ray. This outfit I can recommend to anyone who wishes a high frequency and x-ray outfit. M’f'd hy McB. & D. Co the static machine to take the place of the condenser to obtain certain forms of high frequency currents. The principal high frequency methods employd in medi- cin ar the d’Arsonval, the Tesla, and the Oudin, as wel as those from the static machine. 619High frequency currents oscillate from 10,000 to 50, 000,000,000 times a second. High frequency currents can be employd in many ways to produce sedation, dilation of capillaries, and celular mas- sage. It is also used to produce the Roentgen rays. “Thermic penetration” is produced from the d’Arson- val current, and is doubtless a valuable modality, but must be used with a ful understanding of just what it is capable of doing. Unless you ar wel qualified, do not attempt to employ “thermic penetration.” Auto-condensation is a very important modality used in connection with high frequency currents. Its value in the treatment of arteriosclerosis is wel known—consequently its value for treating apoplexy or nefritis. To lower high blood pressure, this modality is very valuable. High frequency currents ar germicidal; they increase internal body resistance; disintegrate calcareous deposits in the arterial system; lower blood pressure; enhance elimina- tion; liberate pure ozone; righten and increase metabolism. The x-rays possess therapeutic values similar to other high frequency currents. For fluoroscopic and radiografic work, the x-rays hav no substitute of proved value. Oxygen and Allotropic Oxygen or Ozone, can be pro- duced by high frequency currents; and the inhaling of prop- erly produced and “‘washt” ionized air (oxygen vapor) is of great therapeutic value. Altho high frequency currents hav been used a good deal, yet high-power incandescent lamp radiations as wel as the quartz light, ar rapidly taking their place. Probably the ignorant use of high-frequency currents hav done more to hinder the progress of electro-therapeutics than anything else. Where I formerly used high-frequency modalities and static electricity, I now use powerful-radiant light and the sinusoidal modalities. I find them more dependable and satisfactory in every way. Caution Wirth X-Ray or Raprum No doubt x-ray in the hands of some is very efficient, but from what I hav seen of x-ray work, the results seem to be as much as x quantity as the ray itself. For instance, acne, which some claim to cure so easily with x-ray, may be cured, but, as a rule, the condition of the skin afterward is 620not what we would want charged to our account. I hav had occasion to treat a good many post x-ray cases, and it may be that is the reason why my x-ray tubes ar not being used as much as formerly. I hav found that the Quartz Light wil do far more therapeutically and in a safe manner, than can be done with the x-ray. As to radium, I hav had no experience with it, and probably never shal hav. From my conception of radiations and vibrations in matter, it seems that the radiations of radium ar among the most uncertain that one can deal with. We hear very many good reports, but there is a side that we do not see publisht. My advice is to let the “big man” use radium, but tel your patients to keep away from it. There may be a time when radium can be used as an exact remedial agency, and no doubt some good has been accomplisht with it; but it is a notisable fact that when some people buy a thousand or ten thousand dollars’ worth of radium, the an- nouncement gets into the public press. As a means of “‘ethi- cal advertizing” there probably has never been anything more advanst. (Perhaps “twilight sleep” or “‘serums from abroad” hav gone radium “one better.’’) @21CATAFORESIS Before going into the electrical treatment by catafore- sis, it might be wel to mention something of the fysics gov- erning this electrical process. Cataforesis really means electric osmos. The radical meaning of the term is “electric push,” but this is mislead- ing. In reality it means the difference of level in two liquids on opposit sides of a diafram, causd by the passage of an electric current. The higher level is on the side toward which the current flows. Any substance to be diffused within the patient by cataforesis must be capable of forming a chemic compound. Neiswanger says: “All metals and all bases, whether they be metallic bases or alkaloidal bases, ar electro-positiv in caracter and wil seek the cathode. The three conditions necessary before electrolysis can take place ar: “1. The substance must be a conductor of electricity. “2. It must be a fluid or semi-fluid. “3. One of these elements must be a metal. “Whenever we hav water, we hav a metal—hydrogen. Whenever we pass a constant current thru any substance having these three conditions present, electrolysis of the substance is produced in direct proportion to the flow of current maintaind. It is evident, therefore, that whenever we place medicament upon either pole of a constant current electrolysis of the medicament takes place because such medicament always has present the three conditions men- tiond; and the pole from which we apply the medicin de- pends entirely upon the part of the medicin we want the tis- sues to take. Lhe anode is only used when the base or metal is the part of the compound desired, but when we would utilize the acid, or that which takes its place, as iodin in potassium iodid, the solution must be applied from the cathode. “The action of cocain by cataforesis is much better and quicker than by hypodermic injection and seemingly without the danger of the latter process. We ar able to produce the most profound anesthesia thru the skin into the deeper tis- sues. Opening abscesses, removing small growths, and many minor surgical operations ar done without any appreciable pain to the patient. 622“If to this mixture we ad an equal amount of adrenalin solution, the tissues ar almost immediately blancht and the operation is made bloodless.” Inasmuch as quinin or cocain, or any of the other alka- loids, ar alkaloidal bases, they wil seek the cathode. There- fore they must be applied from the anodal terminal, that is, from the positiv pole. The same applies to any basic salt, such as zinc or copper sulfate, or the metals themselvs. Thiosinamin is a bitter crystallin substance formd by treating volatile oil of mustard with ammonia. It is soluble in water, alcohol or ether and has a selectiv action for scar tissues. If we wisht to diffuse this substance thru the tissues by electrolysis we would put the thiosinamin solution on the basic pole, that is, on the positiv terminal. Before I leave the subject of cataforesis in the treat- ment of disease, I wish to state that if one fully understands the principles underlying the use of the constant current and realizes just what can be done by means of cataforesis, there is really no end of work that can be done by it. Dr. Massey, of Philadelphia, has proved beyond all doubt that cancers, as wel as many other growths, can be easily and effectually cured by single or bi-polar ionization by means of zinc needles. One does not hav to hav a metal in solution to use it cataforically, as the water in the tissues wil act with the soluble metal, causing an interchange of ions. Dr. Mas- sey’s book is very explicit. I hartily recommend both Dr. Massey’s and Dr. Neiswanger’s books. 623Parr Focr. Lecrcre V. ELECTRODES Any one practising electrical therapeutics should look wel to the kind of electrodes he uses. They ar to the elec- trical therapeutist what the mecanic’s tools ar to him. Some persons wil do good work with “any kind of a tool,” but a good deal of one’s success lies in having proper implements to work with. I want to especially mention about the indifferent elec- trode. This I hav found by long experience to be best made of clay. I have tried all kinds of felt cloth, cotton, Fig. 212, The clay pad such as I use for the indifferent electrode. 4 is the Conducting Cord attachment or Terminal to be used in clay pads. fiber, sponges, etc., but none can compare with clay. Ordi- nary modeler’s clay wil anser very wel, but the best I hav seen is a special clay manufactured by the RadiumactiV Co., Columbus Ohio. This clay when mixt with one part of glycerin to nine parts of water and a few drops of win- tergreen added, makes an ideal pad. It holds its place and is an excellent conductor of electricity. Fig. 212 illustrates this clay electrode. It should be wrapt in cheesecloth and kept in an electric sterilizer, Fig. 213, or any double-bottom steaming receptable. The bot- tom of such a sterilizer should hav legs about half an inch long solderd on so the pad wil not lie in the water. 624Just before using it, the water can be heated and the steam wil heat the electrode to make it comfortable and at the same time keep it moist. I keep one piece of cheese- cloth on the clay pad all the time so as to hold it in shape and make it easier to handle. These clay electrodes can be made of any convenient size, depending upon the part of the body over which they to to be used. For the abdomen three or four inches square is needed. They can also be molded in shape to lay over one or two vertebrae, over the chest, on both sides of the nee, and in fact any place on the body, and they wil remain in place. Some put the metal tips of the conducting cord into the clay pad. This is bad practis as the wire terminal soon corrodes and a poor connection results. Fig. 213. The kind of electric sterilizer I warm the clay pads in. Fig. 212 shows a little Conducting-Cord Attachment or Terminal made of copper, and the copper for the cord tip is solderd on at a slant. I devized this cord tip insert so as to leave the metal tip out and hav it so it wil not touch the bare skin of the patient. Over the patient’s skin I put a piece of plain cheese- cloth that has been wet in plain warm water, first rubbing the skin with it so as to make it uniformly moist. I then place the coverd clay pad on this piece of cheesecloth. By following out this tecnic, a piece of clean cloth is always used on the patient’s body and the procedure is a sanitary one. 625Cotor oF ConNECTING Corps In connecting up electrodes with a wall plate, or other apparatus such as the polysine or universalmode, I always use a red cord for the negativ side and a blue cord for the positiv side. This facilitates the work when one is using galvanism, and is convenient when using any modality. When the cords ar both alike, one has to handle them over to find out where they go, especially if long ones ar used. A Sanp Pap To hold the clay electrode in place and to giv better contact with the skin, as wel as to enhance the ergothera- peutic effect of the electrical modality, I use sand pads over the clay pad. Fig. 214 illustrates the sand pad that I use. This pad is about fourteen inches long, nine inches wide and thick enuf to make it of any desired weight. The best Fig. 214. Showing a sand pad such as I use over clay electrodes as illustrated in Fig. 148 method of arranging this is to hav one pad weigh ten pounds, another fifteen pounds, and another twenty-five pounds, the weight depending upon the part of body we want to treat. These sand pads ar made as follows: A regular bag is sewd of the correct size and then turnd wrong side in. The required amount of sifted, beach sand is put in after it has been thoroly baked and sifted. The bag is sewd up and another bag of hevier muslin is put over that. Over that is put a bag made of stork sheet- ing so as to make it waterproof. If the sand is kept in this manner, it wil always conform to any shape that is desired. Fig. 148 shows how I use one of these pads on the patient’s abdomen. I first place the clay electrode on the abdomen as before described. Then I connect the conduct- ing-cord, C, to the clay pad terminal. B represents a piece 626