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Page 22 text:
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Luminous infrared radiation being applied with an extremity baker Short wave diathermy using the technique of electro- magnetic field heating Resistance exercise on the shoulder wheel designed to increase strength and range of movement in a patient who had suffered extensive burns in an industrial accident believe to be the truth today will be regarded as error by the next generation. Only continuing research can give us the facts out of which come hypotheses approximating the truth. Since a plausible explanation of the beneficial action of a remedial agent may be fallacious, the truly scientific physician is not satisfied with a possible explanation of its mode of action, but desires also to know the precise relation between dosage and effect. Planned experimentation, keeping all factors constant except one, and subsequent analysis of the results and the gathering of controlled clinical observations (the major scientific approaches to medicine in general) are equally applicable to physical medicine. Unfortunately, basic animal research is sometimes difficult, since we can better
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Page 21 text:
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mediocre empiricism, on personal experience, or even only on the faith of those who believe in physical therapy. Since, as a rule, medical students learn about physical therapy only occasionally, and then superficially in the last two years of their schooling, it is not astonishing that those with an aptitude for research turn away from physical medicine to follow other pathways with scientific traditions well estab- lished by generations of scientists and clinicians. The problems of wartime rehabilitation have opened the eyes of large numbers of physicians and laymen to the needs of an adequate scientific knowledge of the principles of physical therapy. If funds for research can be obtained as readily for problems in physical medicine as for others, clinical work and research in the field will increase and improve. However, progress driven only by economic incentives, un- supported by educational efforts, will be slow. Students and young physicians must be impressed with the fact that the dif- ference between the scientific foundation of physical therapy and that of drug therapy is not so great as it seems at first glance. The advances in our general knowledge in physiology, especially those concerning vascular regulations, lymph formation an d transport, action of the autonomic nervous system, and photodynamic reactions, to name but a few, enable us to visualize, to some extent at least, how various physical therapeutic agents may influence certain body functions and pathological processes. It is important to realize that much of the basic research performed in other fields of medicine has accomplished nothing more than the elaboration of probable mech- anisms for the mode of action of accepted therapeutic measures. It is not a peculiarity restricted to physical medicine that all the mechanisms involved in the curative effects observed are unknown. What physician will refuse to use colchicin for his patients with gout on the grounds that we have not the least idea in what precise manner colchicin acts on the abnormal metabolism responsible for the gout syndrome? Similarly, digitalis and many other effective drugs were used long before we could visualize the mech- anism of their actions. Again and again experience has demonsttated that what we New ultraviolet lamp in use in the M. C. V. Hospital physical therapy department A corner of the Baruch Center ' s basic research laboratory
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Page 23 text:
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simulate acute diseases which are usually treated in man with drug therapy or surgery, than those chronic conditions seen in many patients sent to the physical therapy department or spa because of failure or lack of promise of drug therapy or surgery. In practice, sharp division between basic and clinical research is impossible. Both have to work hand in hand. There are many problems which should be attacked simultaneously by a co-operating team of workers, each having some specialized training in one or more of the numerous experimental, theoretical, and clinical problems involved. The field for investi- gation in physical medicine is very wide — in fact a virgin one. The task of present-day research in physical medicine can be epitomized in a series of aphorisms based on those of Baruch for hydrotherapy: (1) To procure sound scientific proof of the biological actions brought about by physical agents. (2) To determine the exact relation between quality or quantity of the agents and the effects produced. (3) To offer plausible theoretical explanations for the effects observed and for their dependence on quantity and quality of the physical agents. (4) To provide methods to make the effective agents easily accessible in the needed and controlled quantity and quality. (5) To evaluate critically the therapeutic and diagnostic use of biologically effective physical agents. The positive negative pressure boot in the treatment of peripheral vascular dis ease
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