How to Treat Infantile Paralysis.

New Zealand Graphic, Volume XXXI, Issue XVII, 24 October 1903, Page 64

How to Treat Infantile Paralysis.

The child must be clothed very warmly : it cannot take sufficient exercise to maintain the circulation, and. moreover, the circulation in itself is languid, so that day and night it must be well wrapped up. and wear flannel bedgowns. Then, besides the general clothing, the paralysed limb must be protected against the cold by long stockings, drawers. or jacket-sleeves : and if these do not suffice they must be padded, and an equivalent be worn on the limb at night. If the affected limb is reit, its lowered temperature will be most evident to the touch. The use of the hot bottle in bed is not recommended: it is not so effective in improving the circulation as the warm garment, and. moreover, the child may burn itself, and thus cause a troublesome sore. In the case of children with dirty habits, or whose affliction gives them no control over the natural functions. the question of warm clothing is a problem; and if the flannel or quilted drawers have to be abandoned, the child’s loins should br swathed in a flannel wrap, which can be easily changed and washed, something like the baby’s pilch. The most important part of the treatment will be the rubbing and the passive exercises, and these, to be of any avail, must be done regularly and in an orderly manner. The rubbing must be done upwards, following the course of circulation, and make use of some simple oil or liniment, one that will not irritate the skin. Supposing it is the leg that is affected, place the child on a chair, or in some convenient posture for manipulation, then take the leg in the left hand and rub firmly upwards to the loin with the right hand until the skin is red: next, with the fingers and thumbs to the back of the leg in front, take a grasp of each side of the leg and flatten out the muscles between the fingers and thumbs: do this up the leg and repeat: next grasp round the leg with each hand, and work them in opposite directions, like wringing clothes: then do up the limb: next flip over the whole surface of the limb by flicking tSe fingers lightly over the leg. then rub gently up and down, which will remove the stinging. A very important exercise i< to put the rwht hand on the knee, anu to push up the child’s leg with the left: the object is to get the child to push its foot against the hand with all its might. This exercise is very important. All these exercises can be modified to suit the arm and hand. Once a day pour a large jugful of warm water containing two handfuls of salt down the limb: follow this with half a jugful of cold water, and then give plenty of friction

with a rough towel until the limb is warm. In planning the passive movements, it must be taken into consideration what set of muscles are paralysed, and how they can be most efficiently exercised. In the arm the deltoid and the biceps are often affected. The deltoid is the muscle that is concerned in raising the arm above the head; it is spread out over, > the shoulder in shape like a Greek A'l (delta), hence its name deltoid. When-I paralysed and shrunken, the head of thef long bone of the arm (the humerus) carj be plainly seen in its place in the shor’* der socket. The biceps are the rouble IF* muscles in front of the arm. and i eft brought into play in lifting any weightJH rowing, or athletic exercises. A simplefe* exereise for these muscles is to pull ae a weight attached to a cord running overfl a pulley; the pulley may be fixed infl the lintel of the door, and the free endfl of the cord when the weight is on thefl ground should hang just above thefl child’s head. Care must be taken thatl only the affected arm is used and thatl the weight is not too heavy at first :l its weight may be increased as the rr.us"

cles grow stronger. Have a swinging bar suspended in the same way. and when the child is holding with both its hands let it be pulled up until the feet a.e off the ground, and also let the child swing by the bar. Going up and down a ladder will strengthen the grasp if it is weak. Where money is not of much moment, it would be a good thing to , buy one of the self-propelling carriages. | in which the movement is worked by the I hands and arms, somewhat resembling ■ rowring. When the mother has grasped I j at what to aim at. a little ingenuity ! Swill devise the means. JF In the case of the feet and legs, there gis more difficulty, for the weak limbs Kwill not bear the weight of the bodv. Land so they cannot be pu* through their B natural exereise; it will therefore be ■necessary to devise some means by ■which the legs can walk without bearing ■the weight of the body. For this pur~ ■pose various go-carts have been inventfled. all more or less objectionable, the ■srreat objection being their weight. A ■go-cart should be as simple and light ■ in its construction as possible, having •good-sized easy running wheels — four

wheels, not three, are best. The part on which the child’s arms rest should be made out of a square of wood with a hole in the centre; this gives such a stable support. In the case of an older child, the upper part might take the form of ,'crutehies. adjustable to sty height, so that the go-cart would be strong crutches on wn« els. Tn such a machine as this the child could lie taught to walk, and it would feel secure. Another good exercise is to set t K e child on a tricycle horse; this is a capital fomi of movement, and the child likes it. The child should be encouraged to get about bv the furniture, and to pull itself up on to its feet. The* mother should watch for any tendency on the part of the muscles to contract. In all cases these muscles of movement are attached to the bone by a tendon or ligament. This tendon is simply all the fibres gathered, as it were, into a rope, one end of which is attached to the bone. These tendons nay contract, as in the case of that at the back of the heel, the Achilles tendon drawing the limb out of position. They may also be sought for in the groin, at the back of the knee, at the wrist, etc. Passive movement will do much to coun teract this evil—that is. moving the joint backwards and forwards, up and dowr : this will lubricate the joint and stretih the tendon. In severe cases it is often necessary to resort to the surgeon s knife, by which the tendon is divided and the limb then put in its right position in some fixed apparatus. The natural action of the tendon is no* impede I bv this operation. The diet should be nourishing, “nd much milk should be given.