LITERATURE 259 



The compression may be continued for a long time. I have carried on this 

 treatment for several months at a time. Bier has lately, however, advised 

 us to use the method for only one or two hours daily. 



The effect is at first to decrease the pain to such a degree that, for example, 

 the tearing pains of gonorrheal arthritis soon cease, giving way to a feeling 

 of well-being. 



The rule which Bier has expressly emphasized is this, that the stasis itself 

 must never produce pain; as soon as this appears, the bandage must be 

 loosened or removed. 



The further effect of stasis is to increase absorption. It is evident at 

 once that joint effusion, edematous infiltrations of the capsule, and prolifera- 

 tion of the joint villi are more amenable to some treatment than are ecchon- 

 droses and osteophytes, that, therefore, the dry atrophic form of chronic 

 arthritis is less susceptible to treatment than the hypertrophic proliferating 

 forms with their spindle-shaped joints. Bier's hot air and stasis treatment, 

 judged by the results, is by no means a panacea. The physician treating a 

 ease of chronic rheumatism must decide which symptoms most urgently call 

 for relief. Fresh joint and capsule swellings require rest, the alleviation of 

 pain, and the application of remedies which increase absorption, such as the 

 salicylates, iodin, and heat. Older capsular contractures, in which immobility 

 and fibrous ankylosis have occurred, require active and passive movements and 

 the condition is often relieved by stasis. Muscular atrophy is benefited by 

 faradic treatment and, above all, by massage. Contractures require applica- 

 tions of heat, prolonged baths, hot air or steam douches, peat or fango poul- 

 tices, and protection from cold. 



The earlier the treatment is begun, the better the result. 



Firm ankyloses and hyperostoses, particularly of the larger joints, require 

 surgical and orthopedic treatment; practice with suitable apparatus may im- 

 prove the gait, and prevent the bad consequences of too great weight upon 

 the vertebral column. The operative treatment of mono- and polyarthritis, 

 according to the few results reported by W. Miiller and his pupil Elter, 

 deserves further trial. 



LITEEATUEE 



A very complete compilation has recently been given by Pribram in Nothnagel's 



Handbuch, vii, 2. 

 C. Adrian, "Ueber Arthropathia psoriatica." Gremgebiete der Medicin, 1903, xi, 



p. 237. 

 W. Anschutz, "Ueber die Versteifung der Wirbelgelenke." Gremgebiete der Medicin, 



viii, p. 461. 

 Bannatyne, Wohlmann and Blaxall, Lancet, 25, April, 1896. 

 Barjon, "Radiographic appliquee k I'etude des arthropathies deformantes," Paris, 



1897. 

 Bechterew, "Steifigkeit der Wirbelsaule." Neurologisches Centralbl, 1893, und 



Zeitschr. f. Naturheilkunde, 1899, xv. 

 Beer, "Rigiditat der Wirbelsaule." Wiener med. Blatter, 1897, Nr. 8 u. 9. 



