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Summary The rheumatoid shoulder is a frequent manifestation in the rheumatoid patient. Most of the symptoms are of a mild to moderate degree and can usually be ameliorated by heat, massage, and gentle exercise. Local injection therapy may be of value in selected cases. Strenuous exercise or manipulation is contraindicated. Tendon ruptures and rotator cuff tears are not amenable to surgical reconstruction and are adequately treated with a conservative regimen. Prophylactic synovectomy is not performed as a routine, because the majority of patients do not develop disabling symptoms. This procedure is usually restricted to the few patients who exhibit uncontrollable proliferative synovitis. Prosthetic replacement is employed for intractable pain with full anticipation of limited mobility. Various designs of a “total shoulder” are undergoing clinical evaluation, but their application has not been defined.

The “executive” massage parlor, ostensibly offering relaxation and physical therapy, may often operate as a deviant service system offering masturbation as compromise sexual gratification in competition with traditional forms of prostitution. The young women who work as masseuses, attracted by the remunerative financial opportunity, reject the occupational label and role of prostitute but are willing to assume the responsibility and self‐image of “hand whore.”

The study was designed to produce objective data on the rate of local cooling following the ice massage technique of cold application and the rate of rewarming following termination of the ice application. More importantly, the onset of skin analgesia and its duration were evaluated. Sixteen normal subjects participated in four testing sessions, two of which were control session. A thermistor unit with probes monitored skin temperature and a standardized pain-evoking stimulus was used to verify analgesia. Analgesia was elicited by the ice massage only after the localized region had been cooled to, and maintained below, 13.6 degrees Celsius. The rate of cooling for the localized skin was more rapid than the rate of rewarming. The ten-minute ice massage was an effective procedure in achieving analgesia and, thus, may be sufficient to permit therapeutic exercise of selective painful conditions during, and for approximately three minutes immediately following, application.

We investigated the possibility of significant corneal trauma (as revealed by slit lamp observation of the fluorescein instilled eye), and massage effects following determination of intraocular pressure with the A. O. Non-Contact tonometer (NCT). Fifteen different, normal human eyes were each applanated 150 successive times with the NCT; leading to the conclusion that only minor, superficial corneal epithelial defects sometimes resulted and that, in line with other studies, the initially higher readings (about 1 mm), obtained with the NCT, were most likely due to patient apprehension, while the subsequently lower readings represented patient acceptance of the process and were not a result of true aqueous massage. As in an earlier study, we found the instrument's variability to be about plus and minus 1 or plus and minus 2 mm and probably due to the subject's own cardiac cycle.

To evaluate effectiveness of three commonly suggested methods of preparing the breasts for breastfeeding--nipple rolling, application of cream, and expression of colostrum--57 women volunteered to prepare one breast and not the other. One-third of the group used one each of the three methods. After delivery, the women completed data sheets on the subjective tenderness of both breasts, and an investigator visited them to evaluate objective measures of nipple irritation. When the treated and untreated breasts were compared, no significant differences in either objective or subjective measures of nipple sensitivity or trauma were found in any of the three groups. These findings imply that these traditional methods of preparing the breasts for breast-feeding are ineffective.

Ours is a developing country. We have still not controlled the common infectious diseases which are extinct in the West; therefore, our limited resources are spent on study of epidemiology of infectious diseases. My conclusions on epidemiology of cancer of the larynx are drawn from observations made of the clinical material over a period of 25 years. I have come to the conclusion that the smoked tobacco and the slaked lime in the Indian "Pan" are the two important carcinogenic agents. Poor nutrition appears to be carcinogenic. It requires study and confirmation at a cellular level. Misuse of voice does seem to be the cause of laryngeal cancer. Racial, genetic and other environmental factors, including pollution have not contributed to the increased incidence of laryngeal cancers. The common histological types of laryngeal cancer are known. My observations on certain biological behavior of the tumor have been helpful. 1. An exophytic growth is less infiltrative; its metastatic mass reflects the same characteristics. 2. Certain anaplastic tumors can flout all laws of cancer spread and metastasize in distal organs. 3. Presence of reticular hyperplasia in peripheral lymph nodes is of good prognostic value.

In the first paper in this series, I discussed the bacterial flora of the small intestine of 4 normal persons and of 20 hospital patients. One of the female patients W. (arthritis deformans) was particularly ready to take the intestinal tube, and was most conscientious in following directions. She was kept at the hospital for several months, at the request of Dr. Coleman, receiving treatments in the form of bakings, massage and vaccine injection for the arthritic condition.

The story of the development of physiotherapy in South Australia covers almost fifty years. It is a story of the generous giving of time voluntarily to institutions and to the organization of the physiotherapists. For many years at least one-half of the massage at the Adelaide Hospital was done by voluntary workers. The value of prenatal and postnatal physiotherapy in hospitals and clinics became evident because of the initiative of enthusiastic physiotherapists who sought permission from the Boards of Management to do the work on a voluntary basis. The same far-sighted generosity has earned recognition in almost all of the avenues into which physiotherapists have carried the services of the profession.

1.Hospital records of 73 patients treated for cardiac arrest at Charity Hospital from June, 1960 through March, 1962 are reviewed. Patients who developed cardiac arrest during or after cardiac or pulmonary operations are not included. There were 54 arrests in the operating room and 19 in other areas of the hospital. 2.Patients were classified according to type of resuscitative procedure employed. These included (1) closed chest massage, (2) open thoracotomy with massage, and (3) combined closed-open massage. 3.The survival rate in the operating room with closed massage as definitive therapy was 90 per cent and when instituted as a preliminary measure to open-chest massage was 35 per cent. There was a 63 per cent survival among all patients in whom closed massage was attempted in the operating room. When immediate thoracotomy was employed for cardiac arrest in the operating room, the survival rate was 21 per cent. 4.The number of patients resuscitated outside of the operating room is too small to allow any general conclusion. The three survivors reported demonstrate the value of closed chest massage as definitive therapy in cardiac arrest and as a preliminary measure to allow proper preparation for open cardiac resuscitation. There was no patient with cardiac arrest outside the operating room successfully resuscitated with primary open massage. 5.This study demonstrates that as the resident staff of the hospital became more familiar with the technique of external cardiac message, the incidence of open thoracotomy decreased and the survival rate from cardiac arrest increased. 6.External or closed cardiac massage has significantly improved survival from cardiac arrest in the operating room and has resulted in successful resuscitation in other areas of the hospital where cardiac arrest is almost always irreversible.

Teeth move in relation to the pressure of soft tissue surrounding them. Habits such as thumbsucking, lip-biting, and deviate swallowing can cause malocclusion. A method of treating such malocclusions in the deciduous and mixed dentition calls for use of a removable appliance and a series of myofunctional exercises.

A resume of the American, Canadian, British, Australian and South African literature is given for the period of 1925 to 1951. The current thoughts upon the etiology, prevention and treatment have been given. When surgeons and anesthetists have become familiar with the altered physiology in cardiorespiratory arrest, many lives are going to be saved among the victims of this condition. It must be realized that oxygen must be gotten into the alveolar spaces and must be circulated by the use of the most efficient method of massage to other parts of the body, most especially the brain which undergoes rapid deterioration in the presence of anoxia. The presence of anoxia for longer than three minutes grossly lessens the chance of recovery.

SUMMARY Massage of the seminal vesicles and ampullae was carried out 68 times during 35 diuresis experiments on 6 sexually mature rams. The animals had received a hydrating dose of water. In 52 cases (76%) definite inhibition of water diuresis was observed accompanied by increased concentrations of chloride, sodium and potassium in the urine. Ejaculation was observed after 42 stimuli (61%). The influence of coitus on water diuresis was studied on 5 rams in 24 experiments. In 17 cases out of 48 (35%) coitus caused definite inhibition of water diuresis together with increased concentrations of chloride, sodium and potassium in the urine. These antidiuretic responses were weaker than those observed after massage of the seminal vesicles and ampullae. Evidence of ejaculation was obtained after coitus on 37 occasions (77%). The antidiuretic action of physiological doses of oxytocin was very low. The inhibition of urine flow induced by massage of the seminal vesicles and ampullae or coitus could be imitated by intravenous injection of physiological doses of ADH. The mean antidiuretic effects in response to massage were matched by injection of 3–4 mu. Pitressin. The mean antidiuretic effects induced by coitus were equivalent to 2 mu. Pitressin. It is concluded that there is a release of ADH in response to massage of the seminal vesicles and ampullae. There is some evidence that a similar phenomenon occurs during coitus.

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1. 1. External defibrillation was attempted in experiments on forty-one dogs. In all instances the heart could be readily defibrillated, as indicated by the electrocardiogram. However, a return of pulse and blood pressure seldom occurred beyond a fifty-second time limit. 2. 2. In experiments on seventy dogs the heart was permitted to fibrillate for 120 seconds before a countershock was directly applied. Electrical defibrillation promptly occurred but there was no return of systemic blood pressure. Following immediate massage there was a quick return of a coordinated beat and a normal blood pressure. 3. 3. In experiments on eighty-three dogs the heart was allowed to fibrillate for 120 seconds; then ventilation and massage were instituted before a direct countershock was applied to the ventricles. This was followed in each case by normal circulation and eighty-three survivals. 4. 4. For successful cardiac resuscitation, the re-establishment of the oxygen system is the primary act and the restoration of the heart beat is secondary. 5. 5. It appears that it is a minor problem to defibrillate the heart through an intact chest. However, to restore the life functions of an animal after some fifty seconds, supplemental measures have to be taken such as cardiac massage, or intra-arterial transfusion or infusion. 6. 6. Under ideal circumstances, when a trained team and equipment are in readiness in a room, a few seconds spent on external countershocking might be conceivable. We are carrying out additional studies continuously.

Myofascitis is a common condition due to a low-grade inflammation of the muscles and fasciae. Focal infection is the basic cause with trauma frequently acting as the exciting or aggravating factor. The differential diagnosis is difficult as myofascitis simulates or complicates a wide variety of conditions. Treatment consists of improving the hygiene of the patient and elimination of toxicity by a combination of methods; removal of the source of cause of toxicity, local massage, colonic lavage, stimulating the growth of bacilli acidophilus in the intestinal tract and attention to diet. Local mechanical treatment is also applied when necessary.

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1. 1. Ammonium iodoxy benzoate is of definite value in the treatment of gonorrheal arthritis. It is best used as an adjunct to the usual orthopedic measures: (1) short period of rest, preferably in plaster, for four to ten days; (2) physical therapy: diathermy, massage and active motion as soon as the pain disappears. In the milder cases its use permits a patient to be ambulatory who might otherwise be confined to the hospital. 2. 2. Insufflation of the knee in the synovial type of gonorrheal arthritis is described. We feel it hastens resolution of the process, promptly relieves pain and thus permits early motion, preventing the formation of intra-articular adhesions and muscular atrophy from prolonged immobilization. 3. 3. Aspiration, irrigation or even drainage is sometimes necessary for the purulent type of infection, but amiodoxyl again seems to hasten the resolution and certainly relieves the discomfort. Splinting in a position of rest is necessary for a time, but early motion should be started as soon as the acute stage is over and pain is relieved. With this, diathermy and massage have been found to be the most valuable type of physical therapy. 4. 4. Hyperpyrexia by fever diathermy is useful, especially in refractory cases. 5. 5. Twenty-two cases are reported, 11 of which were treated with the adjuncts already described. Of these 40 per cent were completely cured, 40 per cent much improved and 20 per cent developed ankylosed but painless joints. The remaining 11 are presented for comparison and received neither amiodoxyl, insufflation nor hyperpyrexia therapy. Of these 30 per cent showed no improvement; 10 per cent recurred; 20 per cent resulted in ankylosis; 40 per cent showed slight improvement. Six cases in which the advocated treatment was used are reported in detail

We believe that the levator spasm syndrome, coccygodynia, and chronic prostatitis are disorders which frequently may cause rectal pain. In these conditions, the diagnosis may be overlooked easily, due to the vague and unusual terms in which patients describe their complaints, or because of coexistent, unrelated, anorectal disorders. In the presence of vague rectal pain, digital examination should include all pelvic structures within reach of the finger.

Congenital torticollis must be diagnosed early so that the simple treatment can begin before fibrosis develops. In brachial paralysis of the newborn, massage and exercise are effective but a brace or cast may lead to contracture. Treatment of spina bifida should start immediately after birth to prevent contracture. Since the condition is lifelong, the child and his family will need encouragement to avoid the frustration inevitable in a prolonged, difficult program.

To use massage cream effective on periodontal diseases and to massage gingiva as daily preventive means for periodontal diseases is a simple but effective measure by giving the idea for the prevention and treatment of periodontal diseases.In order to prove this fact, studies were made by the use of Hinokitiol massage cream.As the materials, adult female 27 patients were employed, they were suffering from periodontal diseases.And they were instructed to make massage on gingiva at the frontal part of the teeth with fingers by the use of Hinokitiol massage cream everyday, morning and evening, for 36 days continuously.As for observation methods, objective symptoms were observed on the index related to epidemic research of periodontal diseases, while, subjective symptoms were observed by checking questionaires, also pathological tests were combinedly performed.As the result of comparing objective symptoms after making massage, marked reduction of index was observed after massaging than before. In calculating the reducing rate, the following order was observed from its high rate to low; OH I followed by bacterial plaque score, PIA index and Periodontal index. And also, subjective symptoms were decreased after making massage than before, proving the following order on the reduction rate; bad breath, swelling, bleeding from gingiva and teeth mobility.While subjective symptoms proved the following order of reducing rate; bad breath, swelling, bleeding from gingiva and tooth mobility. As for pathological findings, the finding under the gingiva attached epithel was more improved after making massage than before. In conclusion, the progress of subjective and objective symptoms proved that continuous use of the above cream was very effective in the progress of treatment for more than 28 days.

1. Chronic distress rarely follows a well-performed primary amputation. The proximal nerve ends are probably best dealt with by clean division and recession into mobile, well-nourished tissues. 2. One workmanlike remodeling of a badly constructed stump is advisable, with concurrent resection of any neuromata found. Further procedures of this type are worse than useless. 3. Percussion or massage of the tender area seems to promise much, and many patients discover this of their own accord. The trauma inherent in daily use of the hand is probably helpful in abolishing hypersensitivity and phantom-limb sensation. 4. When well-conceived local treatment fails to relieve, it is vital to turn without delay to the autonomic nervous system. If sympathetic block fails to relieve, it is useless to carry out sympathectomy. High chordotomy should relieve pain if done in time, but procrastination may leave the patient without prospect of relief except through the drastic medium of leukotomy.