ONE of the outstanding events in physical medicine during the last two years was the publication of an excellent textbook by Krusen.1 There has long been a need for a reference book to which the student or practicing physician could turn for sound and detailed information on the practical aspects of physical therapeutics. Krusen is an authority on the subject, and has had unusually large experience in clinical application and investigative work. In addition to comprehensive presentations of the subjects of heat, light and electrotherapy, he has included the technic and indications for the use of hydrotherapy, massage and exercise -measures that have received little acclaim recently because of enthusiasm concerning electrical apparatus, which actually have only a small role in physical therapy. The present knowledge of the physical and physiologic principles involved has been summarized, with extensive references. The illustrations and explanations of simple measures that may be used in the home are especially valuable.Hypothermia has recently been found to have more new useful applications than any other physical measure. Many investigative studies have dealt with the physiologic changes and therapeutic effects of the reduction of general body temperature and the local use of cold. The present status of this therapy has been reviewed by Talbott.2 Recent developments in the use of the majority of other physical agents are presented in relation to the different medical specialties.
MedicineIn the treatment of rheumatoid arthritis and degenerative joint disease, physical measures continue to have a significant role. In these conditions with a tendency to chronicity, simple procedures that can be carried out in the home should be emphasized. Krusen3 has outlined specific instructions for the use of homemade bakers, clamp lamps, hot paraffin packs, whirpool baths and contrast baths. Massage, when skillfully administered on nonacute joints, is beneficial, and a lay person with proper instruction may learn simple technics that are of value in improving local circulation and in relieving muscle spasm. It is recognized that training in body mechanics is effective in preventing undue strain and trauma on diseased joints.4 Postural and specific graded exercises for increasing joint range and muscle power are probably of more benefit than any other physical measure when properly supervised.5 Diathermy,6 cabinet baths and more elaborate types of treatment have a place in hospital departments.7 However, results of fever therapy in rheumatoid arthritis and osteoarthritis have been disappointing.8 Iontophoresis with histamine and acetylbeta-methylcholine chloride has given encouraging results,9"12 but has not replaced other simpler agents for symptomatic relief. Neurologic symptoms may accompany cervical degenerative arthritis, and much benefit may be obtained by heat, massage, traction, manipulation and posture training.13 The temporomandibular joint is frequently involved and often is not treated adequately. Bayles and Rus...
