BLUNDELL'S IENDICINA NECHANICA. a Twig object of Dr. Blundell's book is
to introduce to the British public the Swedish physiciarr Ling's system of exercises or mani- pulations as a means of cure in chronic disease. These move- ments have nothing whatever in common with the passes or movements of the mesmerists, but aini at curing disease and re- storing health bymechanical action on the muscles and circulation, so as to effect a fresh distribution of blood, removing it from organs where there is reason to suspect congestion, and causing it to flow to organs which are suffering from too little. The principles upon which this system is based are so enveloped in pedantry used into jargon, that it would be difficult to explain because it is hard to understand them: a sufficient idea for popular comprehension may be gathered from an incidental argument. "Although muscular exertion does not actually interfere with the routine -of the circulation, it influences that routine in several ways. In the first place, the over-activity of a part, whether it be of the brain, secreting organs, muscles of voluntary or organic motion, determines a flow of blood towards that part; and this determination, slow at first, gradually acquires strength—is, in truth, newly educated to a wrong fnotion, and congestion follows, with its after-chain of consequences. It would be as easy, then, for the practitioner to avail himself of his knowledge of this train of events, and to lessen if not remove such congestion, as to apply the many impotent me- thods which medical art has long since condemned. If the blood follow, in sure order, the movements of muscles or other portions of our systems in a healthy state, it will do so in disease, on our exercising those movements locally which our judgment may indicate. And when we consider the ex- tent and surface of the muscular tissue alone, we shall have no trouble in finding out methods to relieve oppressed organs or parts. A thorough ac- quaintance with the principles of anatomy and physiology is alone requisite : further there is no experimental theory in the matter."
The exercises are of three kinds,—passive, active, and mixed. The passive are performed by the operator on the patient, and consist of friction and percussion. in various motions and modes ; in other words, the patient may be rubbed by an up and down or a rotatory movement with the palm or the cage of the hand; he may be smartly tapped with the tips of the fingers, or slapped with the hand, and so forth. In active exercise the patient is the agent, —as in resting his feet against a support while he raises his body by means of his hands and arms, with similar exercises that ap- proach the simpler exercises of the gymnasium. The mixed exercises explain their own nature ; they are sometimes rather like those of a postinemaster. These exercises and manipulations are said to be available in almost every kind of disease, from affections of the heart, apoplexy, and gout, to consumption, indigestion, and ca- chexia or a bad habit of body. Some notion of the application will be obtained from the general directions for the treatment of apprehended apoplexy. " The manipulations in this instance are to be applied to the vessels of the-surface of the cranium, light pressure being made with the thumbs ra- pidly along and above the eyebrows, with fixed vibrations on the arteriert of the temples, thus stimulating the frontal and temporal vessels ; and, by in- creasing the external circulation as it were, the brain will be considerably relieved. Hence we observe, as a result of this, that in a short time the giddiness and dimness of sight, with other distressing symptoms of which the patient complains, are removed. After this, motions of pressure may be performed along the arteries of the neck and throat, as formerly recom- mended by Dr. Parry, though not exactly according to his plan ; then upon the extemal jugular veins; and lastly upon both at the same time. This also assists in relieving the brain. It has also been found beneficial during the operations on the vessels of the scalp, to give now and then one rotation of the head of the patient, the operator at the instant placing his hand with Light pressure on the top of it. But as these are passive manipulations, they should alternate with some active motions, gently, gradually, and cautiously applied to the lower extremities, to divert the blood to those parts. A great advantage is, however, gained by these movements ; and it is this—that the vessels themselves soon acquire a greater amount of strength and elasticity to withstand the pressure of the blood upon their walls. If, then, we con- tinue these passive and active manipulations for some time, and the patient avoid any of his old habits which might have separately or collectively ori- ginated the attack, all the serious symptoms will soon disappear; and even in oases where effusion appears already to have taken place, they cannot be too highly extolled as a means for the promoting of absorption within the basin or its membranes."
This theory may be considered under two points of view,—the curative power, and the probability of patients in general submit- ting to it. That friction is used in many cases we all know ; that it alleviates pain we know—or suppose, for it is possible that the manipulation does little more than divert the patient's attention till the pain is lessened from other causes. We also know that muscular action requires an increased flow of blood to the parts ; and that this habitually continued increases the size and strength of those parts, as is the ease with the arms of watermen and the lfte of dancers. But we do not know that this can be done by ar- tificial treatment pursued through brief periods ; nor, if it could, whether it would have the asserted effects. As a matter of logic, the theory seems to failin this, that it appears to direct itself solely to symptoms. Consumption, for example, is probably something behind the symptoms as it were; so is apoplexy ; so, possibly., is all disease ; and though to prescribe for symptoms is often all that can be done, yet all that such a mode of treatment can do is to postpone attack or prolong. life—it never can oure the disease, though Nature may. At the same time, there is sufficient in the theory to warrant consideration and experiment : but herein lies the practical diffi- culty. The majority of patients cannot pay for it; and, unless skilfully done and regularly persevered m, the exercises would obviously be useless. Many of those who can pay would not, on account of the trouble, the novelty, and perhaps the distasteful- • Meeicies Mechanic*, or the Theory and Practice of Active and Passive Exer- cises and Manipulations; considered as a Branch of Therapeutics, and as adapted both to the Treatment and Cure ofU any Forms of Chronic Disease. By John W. F. Blundell, kt.D. Published by Cllirchill.
ness of the exercises : some would appear to be very monotonous, and some liable to induce strain unless very carefully managed.
This new method of cure is not by any means well brought be- fore the public. 'Whether it is the fault of• the original foreign expounders, from whom Dr. Blundell has drawn much of his mat- ter, or whether the fault is his own, the true subject is overlaid with a parade of universal principles, pedantically expressed, not very intelligible, and where understood open to challenge. The claims made for the system are dogmatically proposed; and in lieu of the moderation and reserve which distinguish a man promul. gating doctrines whose principles are not established, and whose facts to confirm those principles are not proved, there is an air et pretension which will tend to throw more_doubts upon the theory than it perhaps deserves.