474 MODERN DEVELOPMENTS OF HAEVEY's WORK. 



One iiii^lit naturally expect that kneading the muscles Avould increase 

 tlie cii'culatioii through them in somewhat the same way as active exer- 

 cise, but, to the best of my knowledge, no actual experiments existed 

 to prove this, and I accordingly requested my friend and assistant, Dr. 

 Tunniclifte, to test the matter experimentally. The method employed 

 was, in the main, the same as that devised by Ludwig and employed 

 by Sadler and Gaskell under his direction. The results were that dur- 

 ing the kneading of a muscle the amount of venous blood which issued 

 from it was sometimes diminished and sometimes increased ; that just 

 after the kneading was over the How was diminished, apparently from 

 the blood accumulating in the muscle, and this dimunition was again 

 succeeded by a greatly increased flow exactly corresi)ouding to that 

 observed by Ludwig and his scholars. 



The clinical results are precisely what one would expect from increased 

 circulation in the muscles, aiul cases apparently hopeless sometimes 

 recover most wonderfully under this treatment. For patients who are 

 stronger, so that confinement to bed is unnecessary, and who yet are 

 unable to take walking exercise, Schott's treatment is most useful, and 

 it may be used as an adjunct to the later stages of the treatment just 

 described, or as a sequel to it. Here the patient is made to go through 

 various exercises of the arms, logs, and trunk with a certain amount of 

 resistance, which is applied either by the patient himself setting in 

 action the opposing muscles or by an attendant who gently resists 

 every movement made by the patient, but graduates his resistance so 

 as not to cause the least hurry in breathing or the least oppression of 

 the heart. Perhaps the easiest w ay of employing graduated resistance 

 is by the ergostat of Gartner, which is simply an adaptation of the 

 labor crank of prisons, where the number of turns of a wheel can be 

 regulated in each minute and the resistance, which is api)lied by a 

 brake, may be graduated to an ounce. The objection to it is the uni- 

 formity of movement and its wearisome monotony. Oertel's plan of 

 gradually walking day by day up a steeper and steeper incline, and 

 thus training the muscles of the heart, is well adapted for stronger 

 persons, but when applied injudiciously may lead, just like hasty or 

 excessive exertion, to serious or fatal results. In Schott's method stim- 

 ulation of the skin by baths is used as an adjunct, and this may tend 

 to slow the pulse, as already mentioned. But in all these plans the 

 essence of treatment is the derivation of blood through a new channel, 

 that of the muscular vessels, and the results in relieving cardiac distress 

 and pain may be described in the same words which Harvey employs 

 in reference to diseases of the circulation : "How speedily some of these 

 diseases that are even reputed incurable are remedied and dispelled as 

 if by enchantment." ^ 



There is yet another consequence of the circulation to which Harvey 

 has called attention, although only very briefly, which has now become 



' The Works of William Harvey, Sydenham Society's edition, page 141. 



