t h i b D ANNUAL COUNCIL MEETING— Presidential Address P R O F E S S O R R A Y M O N D A. D A R T President o f the S outh A frican Society o f Physiotherapy December, 1961 P H Y S I O T H E R A P Y Page 3 T his y e ar 1961 is a n o th e r m o m e n to u s o n e in h u m a n history A s we e n te r th e second d e ca d e in th e second h a lf o f the tw e n tie th c e n tu ry som e m en a re v e n tu rin g o u t in to sDace yet re tu rn to th e e a r th ’s a tm o s p h e re safe a n d so u n d . T his new e ra, to w a rd s w hich m an h as been a p p ro a c h in g since the forces o f steam , e lectricity a n d a to m s have been to som e e x te n t h a rn essed , is o n e in w hich fears o f m any new kinds a re being faced a n d ov e rco m e a n d in w hich P h y s io th e r a p y to m y m in d has p a r t i c u l a r significance. So I am pleased a n d p ro u d to o c cupy y o u r p re sid en tial c h a ir a t this eventful m o m e n t in h u m a n progress. In these sp a tia l a d v en tu res, like th o se o f scaling e a r th ’s highest m o u n ta in o r p lu m b in g h e r d eep est sea, th o se few are chosen w ho, as fa r as h u m a n tests a n d ju d g m e n ts c an fo re ­ tell, a re the fittest b o th physically a n d m entally. T he p ro d u c ­ tio n o f in n u m e rab le such fit a n d c o u ra g e o u s m en a n d w om en is, 1 take it, th e o b jective o f P h y sio th e ra p y a lth o u g h to d a y , as’ p h ysiotherapists, we a re p re p o n d e ra n tly c o n c e rn e d w ith the re-establishm ent o f fu n c tio n in th o se te m p o ra rily d isabled by sickness o r acc id e n t. T h is c a n o nly be a fo re ta ste o f the w idespread role p h y sio th e ra p ists will d isc h arg e a m o n g st fu tu re gen eratio n s o f m a n k in d . Ju s t as the objective o f M edicine is th e p re v e n tio n ra th e r th a n th e c u re o f disease, so th e o b jective o f P h y sio th e ra p y m ust be th e p re v e n tio n ra th e r th a n th e c u re o f th e w o u n d s, d ysfunctions a n d defo rm itie s w ith w hich h u m a n beings are presently c o n fro n te d a n d assailed. All o f us th ere fo re, will have been deeply im pressed by the splendid m ech an ism D r. A . L . Lom ey, th e H e a d o f the D ep artm en t o f Physical M edicine in th e U n iv e rsity o f the W itw a tersra n d has been bu ild in g up in th e Jo h a n n e s b u rg G eneral H o sp ita l fo r th e specific p u rp o se o f R e h a b ilita tio n : fo r p u ttin g the h o sp ital p a tie n t b ack in to e m p lo y m en t a n d m ain tain in g his fitness there. Such m ec h an ism s a re a long overdue re cognition o f th e fact th a t th e ta s k o f M edicine is n o t com plete w hen th e p a tie n t is c ured physically. H e m u st be restored to society: a n in te g rate d , p ro d u c tiv ely fu n c tio n in g elem ent in his o ld o r a new o c c u p a tio n . It is th e p a rtic u la r responsibility o f P h y s io th e ra p y in h u m a n society to e nable its m em bers to disc h arg e th e ir c h o se n fu n c tio n s w ith m ax i­ m um physical efficiency. O th e rw ise they experience anxiety a n d fear. I spoke o f m en in space! W h y ? B ecause o f w eightlessness: the c o m plete rem oval, even if only te m p o ra rily , o f the e m b a rrassm en t o f g ravity. “ It is easy to sleep in o u te r sp a c e ” was the co m m e n t ye sterd a y o f G h e rm a n T ito v , as re p o rte d in Pravda a c c o rd in g to th e R a n d D a ily M a il o f A u g u st 23, 1961, “ there is n o th in g to tu r n o v e r o n . L im b s d o not becom e n u m b . Y o u feel as th o u g h y ou a re o n to p o f a sea w ave.” N o n e o f us c a n read ily u n d e rsta n d w h a t possibilities this new type o f situ a tio n , th e sta te o f w eightlessness, o p e n s up fo r P h y sio th e rap y . Y o u will re m e m b e r w h a t rem edial w ork early a ir trip s in o p e n p lanes d id fo r w h o o p in g c o u g h cases. A n inkling o f c o u rse, is p ro v id ed by th e su p p o rtiv e effect o f w ater, as in sw im m ing a n d sk in-diving a n d th e num berless a q u atic p u rsu its a n d p lea su re s it h a s b ro u g h t to m a n k in d , a lo n g with th e assista n ce re n d ere d by its b u o y a n cy to w eak m uscles in th e p ro cess o f recovery a n d re g ain in g stre n g th . O th e r inklings a re a ffo rd e d to u s w hen we d r e a m ; o r v e n tu re •on swings, sw itc h b ac k railw ays, a e ro p la n e s o r o th e r p re ­ c a rio u s a d v e n tu re s , th a t a t first flush th ru s t o u r h e arts in to o u r m o u th s ; b u t, su b seq u e n tly , as we becom e acc u sto m e d th e re to , give us a ll so m e th in g o f th e th rills o f speed, o r o f ro c k in g u p a n d d ow n, o r o f g y ra tio n a l m o v em e n t as in d ances, o r on to b o g g an s, skates, o r skis. Y et a n o th e r inkling, a n d to m y m in d a vastly im p o rta n t o n e —a n d in terestingly e n o u g h it e m e rg ed from a d e co m p ressio n c h a m b e r— h a s been p ro v id ed fo r p a rtu rie n t w om en, a n d a ls o fo r people, fem ale o r m ale, w ith slip p ed discs a n d o th e r b ackaches, by P ro fe ss o r O . S. H e y n ’s a p p lic a tio n o f re d u ce d a tm o s ­ pheric p re ssu re to th eir bodies. T h e h isto ry o f m edicine, as o f all o th e r b ra n c h e s o f k n o w ­ ledge, is progressive. M a n ’s o u tsta n d in g m en ta l c h a ra c te r­ istic is his c o nsciousness o f w eakness o r fear b ecau se o f his defenceless body, his lack o f b u ilt-in defences a n d w eapons. In infancy he is u tte rly d e p e n d e n t o n o th e rs a n d fears a ny lack o f s u p p o rt; as so o n as he is ill he becom es a g a in th e su bject o f fear a n d anxiety. So, a t first, h u m a n beings a t t r i ­ b u te d u n a c c o u n ta b le illnesses— as still in B ib lical tim es— to m a le v o le n t sp irits w ho h a d to be a p p e a se d o r lib e rate d from th e b ody. T h e e x te rn al spirits o f m a n k in d ’s pre-scien- tific th e o ry th a t th e e a rth c o n sisted o f fo u r essences o r e le­ m e n ts: e a rth , a ir, fire a n d w a te r; a n d h u m a n bo d ies w ere su p p o sed to be c o m p o se d o f fo u r “ h u m o u rs ” o r liq u id s: b lo o d , phlegm , b lac k bile (m elancholy) a n d yellow bile (c h o le ra). D isease w as th e n ex p la in ed as being d u e to excess o r defect o f o n e o f these liquids. By G a le n ’s tim e (A .D . 130-200) th e in te rn a l liquids o r spirits h a d b ecom e th re e : th e natural spirits fo rm e d in the liver a n d c a rrie d by th e veins, th e vital spirits e la b o ra te d in th e h e a rt a n d tra n s fo rm e d by th e a rte rie s a n d th e a n im al spirits fo rm ed in th e b ra in a n d d istrib u te d by th e nerves. T h is w o rk in g c o n c e p t d o m in a te d intelligent m edical pra ctic e fo r th e follow ing 1,200 y ears u ntil, w ith th e R e n aissan c e o f L ea rn in g a n d th e discovery o f th e N e w W o rld a n d o f th e C a p e ro u te to th e e aste rn h a lf o f th e O ld W o rld , increasing k n ow ledge o f o th e r p e o p le ’s sicknesses a n d h e alin g d ru g s re v o lu tio n ised these o ld R o m a n m edical ideas. V esalius a n d his a n a to m ic a l follow ers b ro u g h t to surg eo n s a n in creasingly de ta ile d know ledge o f h u m a n stru c tu re . H a rv ey a n d his e x p e rim e n ta l follow ers o p e n ed u p to p h y si­ c ia n s a n a c c u ra te u n d e rsta n d in g o f b lo o d c irc u la tio n a n d o th e r b o d ily fu n c tio n s d u rin g th e 16th a n d 17th c enturies. T h en th e chem ical discoveries o f th e 17th a n d 18th c e n ­ turies a n d the c ellu la r a n d bacterio lo g ic a l discoveries o f th e 18th a n d 19th c en tu rie s led to o u r m o d e rn k n o w ledge o f in fectio n by germ s a n d viruses a n d th e ir c o n tro l by s a n ita ­ tio n , w a te r p u rific atio n , iso latio n o f p a tie n ts, im m u n isa tio n a n d th e rest o f to d a y ’s p re ventive m ed ic in e ’s a rm a m e n ta riu m . B ut th e 19th a n d 2 0th c en tu rie s have a lso b ro u g h t us ne u ro lo g ists, psy c h iatrists a n d n e u ro su rg e o n s to d e m o n ­ stra te th a t e ac h h u m a n b e ing c onsists n o t o n ly o f a b ody, the p la y th in g o f th e d re a d e d germ s in its physical e n v iro n ­ m e n t b u t a lso o f a n a n x io u s m ind, th e a re n a o f his o r h e r am b itio n s a n d fru stra tio n s, o f th e ir objectives a n d p assions, o f th e ir c o lla b o ra tio n s a n d o p p o sitio n s a risin g fro m each in d iv id u a l’s e n v iro n m e n t in w hich e a c h h a s been reared. W ith th e c a n d id reco g n itio n o f the im p o rta n c e in m edical an alysis a n d tre a tm e n t o f th e p a tie n t’s re su lta n t fear-full a ttitu d e to his ow n life a n d th o se o f h is fellow s in his daily e n v iro n m e n t has c o m e w h a t we have lea rn ed to call the R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) Page 4 P H Y S I O T H E R A P Y December, 1961 p sy c h o so m a tic o u tlo o k . P avlov a n d S h e rrin g to n , F re u d , Ju n g a n d A d le r, c o n ­ d itio n e d reflexes a n d in te g ra tio n o f th e n e rv o u s system , psy c h o a n aly sis a n d in ferio rity com plex, e x tro v e rt a n d in tro v e rt: these a n d n u m e ro u s o th e r m asses o f scientists a n d th e term s to w hich they h a v e given m ea n in g a re to p ics o f c u rre n t w orld -w id e c o n v e rsa tio n as well as o f m edical in v estig a tio n . W h a t a v era g e w ell-inform ed p e rso n is ig n o ra n t o f sh e ll-sh o ck ; o r th e fact th a t a n xiety a n d w o rry p ro d u c e ulcers a n d o th e r a lim e n ta ry d iso rd e rs, a n d c au se c irc u la to ry tro u b le s as well as m en ta l d istu rb a n c e s ? M e d ica l p ra c titio n e rs v ary in th e ir e stim a te s o f w h a t p ro p o rtio n o f th e ills th ey tre a t a re p ro d u c e d by m ental a n x ieties a n d fears as o p p o se d to germ s a n d o th e r p urely physical o r chem ica l fa cto rs. S om e say fifty p e r c e n t ; o th e rs have to ld m e th a t they e stim a te e ighty p e r c en t o r even m ore. So I have been p a rtic u la rly in te rested recently in re ad in g B ody a n d M a tu re Behaviour: A S tu d y o f A n x ie ty , S e x , Gravitation a n d L e arning by M . F e ld e n k ra is (1949) w hose p u rp o s e has b een to sh o w th a t how ever m uch m ay be d o n e by d o c to rs to im p ro v e th e fu n c tio n in g o f h u m a n m inds, “ ra d ic a l c h anges c a n n o t be expected w ith o u t refo rm in g m u sc u la r a n d p o s tu ra l h a b its ” . I t is o nly th ro u g h bodily m o v em en ts th a t m in d s c an express them selves. T h is b ook w as first p u b lish ed twelve y e ars a g o a n d no b o o k is perfect. N o r am I a d v o c a tin g all th a t is fo u n d in th is o n e ; b u t it relates to m y topic. Its su b s ta n c e w as p re ­ se n ted b e fo re th e A sso c ia tio n o f Scientific W o rk e rs in a series o f lectu res given a t F a irlie , S c o tla n d in 1943-1944 a n d th e text w as s u b m itte d fo r c riticism to som e d istin g u ish e d a u th o ritie s b efore p u b lic a tio n . A n y in fo rm a tio n desired, m o re d e tailed th a n it gives, can easily be fo u n d in the n u m e ro u s classical w o rk s c ited th ere in a n d b ro u g h t u p to d a te by a ny o f y o u , w h o c are to delve in to th e m a tte r fu rth e r. T h e c h a p te rs th a t in te re ste d m e m ost fo r th e ir relevance to p h y sio th e ra p ists in p ro d u c in g w ell-balanced p e o p le were the fo u r c o n secutive o n e s d e alin g w ith a n ti-g ra v ity m ech­ anism s, erect p o s tu re a n d a ctio n , se n sa tio n a n d th e v e stib u la r a p p a ra tu s , a n d th e b o d y p a tte rn o f a nxiety. M y in te rest w as seized by the a p p lic a b ility o f th e a u th o r ’s v iew point to the te c h n iq u e o f a v o id in g fe a r a n d a nxiety, th a t I h a d a tte m p te d to o u tlin e fo r d e n tists in The P o stu ra l A sp e ct o f M alocclusion (1946) a n d fo r m y m edical colleagues in The A tta in m e n t o f Poise (1947). I h a d o u tlin e d th e re a m e th o d o f d e aling w ith th e p o stu ra l tw ists o f th e b ody c au sed by th e d o u b le -sp ira lle d a rra n g e ­ m ent o f the v o lu n ta ry m u sc u la tu re (D a rt 1950) th ro u g h o u r u n ila te ra l h a b its, th a t d e stro y o u r e q u ilib riu m . I w ould have fo u n d m u ch , th a t 1 d esired to say th en , e xpressed m ore inte restin g ly a n d , a t g re a te r length in th e lectures F e ld en k ra is h a d a lre a d y given, h a d they been pu b lish ed a t th e tim e o f my e a rlie r w ritings. F o r, as he says (o p cit. p. 83), “ M c D o u g a ll distinguishes fo u rte e n different in stin c ts: p a re n ta l, sex, food-seeking, fe a r o r escape, c o m b a t, c o n structiveness, c u rio sity , re p u g ­ nance, a cq uisitiveness, a p p e a l (rec ip ro ca l o f p a re n ta l instinct), herd in stinct (g reg ario u sn ess), self-assertion, se lf-subm is­ sio n a n d la u g h te r. P a v lo v th in k s th a t th e re is a n instinct fo r free d o m , th a t a n a n im a l o b jec ts to b e ing tie d up o r e n clo se d in a c onfined space lim itin g its m o v em e n ts. H o w ­ ever, even if we a c c e p t fo r a m o m e n t the a b o v e classification, we o b se rv e a re m a rk a b le th in g — that only one o f the instincts inhibits m otion, n a m e ly fe a r o r e sc ap e ” (italics m ine). T h e n F e ld e n k ra is c o m m e n ts o n th e re m a rk a b le sim ilarity o f p h ysical a n d m e n ta l re a c tio n s betw een th o se o f a n ew ­ b o rn b a b e to w ith d ra w a l o f s u p p o rt, a n d th o se o f frig h t o r te r r o r in a n a d u lt: v iolent c o n tra c tio n o f a ll flexors w ith h a lte d b re a th , fo llo w ed in th e in fa n t by crying, acc ele rated pulse a n d v a s o m o to r d is tu rb a n c e ; o r in th e a d u lt by the in h ib ite d d ia p h ra g m , p o u n d in g h e a rt a n d se n sa tio n o f in te n se anxiety. F ro m th a t d ra m a tic a n d e xact c o m p a ris o n h e p ro c ee d s to F r e u d ’s c o n te n tio n th a t a n x ie ty is the c entral problem o f neuroses; a n d to P a u l S c h ild e r’s claim th a t “ d izziness is as im portant fro m th e p sy c h o a n aly tic p o in t o f view as a n x ie ty; a n d his e x p e c ta tio n th a t “ stu d y o f th e v e stib u la r a p p a ra tu s w o u ld have g re a t im p o rta n c e fo r u n d e rs ta n d in g psychotic a n d n e u ro tic s ta te s” (m y italics). M a n ’s p e rp e tu a l fe ar in s h o rt is th a t o f fa llin g : h e c a n n o t tru s t his bod y b a lance everyw here. T h is fe a r o f falling m eans th a t we d o n o t tru st o u r v e stib u la r o rg a n s in w h a t sh o u ld be th e ir a u to m a tic o r reflex disc h arg e o f th e ir b a lancing fu n c tio n s. F e ld e n k ra is then goes in to these q u e stio n s m o re fully th an I c a n g o here a n d rightly in d icates th e successive stages p assed th ro u g h in th e d e v elo p m en t o f th e n o rm a l h u m an in d iv id u a l’s a d ju s tm e n t by v e stib u la r b a la n ce to g ra v ita tio n . T h e test o f c o m p le tin g its p o te n tia l p e rfe c tio n w hich he a p p lie s (p. 113) is: “ he m ust lea rn to b a la n ce easily a n d serenely o n o n e leg, to ju m p , to tu r n h im self a ro u n d , and finally p e rfo rm all these m o v em en ts with the eyes sh u t” . H e a lso p o in ts o u t th a t “ w ith every p h a se o f this d e velop­ m en t the breathing m echanism is a lte re d as d ifferent p a rts o f th e tru n k b e co m e rigid, a n d th e p a rts th a t a re left free to c o n tra c t a n d e x p a n d a re different . . . In fact, there are as m a n y breathing m echanism s as d istinct a ttitudes o f the body. In p ro p e r d e v elo p m en t, b re a th in g follow s a definite rh y th m , u n h a m p e re d by th e p o sitio n o f th e b ody (italics m ine). N o w it w o u ld be a w aste o f y o u r tim e to tell y o u a b o u t th e incidence o f th e p o s tu ra l defects in h u m a n ity t h a t result fro m th is im b a lan c e. I f y ou w a n t th ese figures y ou c a n find th em in m y p a p e rs a n d in th o se o f th e a u th o rs to w hose w o rk s I h ave re fe rre d . I e stim a te d th e n th a t b a rely 10 per c en t o f h u m a n ity ev er c am e to e x perience w h a t p o ise o f th e so rt F e ld e n k ra is describes really w as physically a n d m en ­ tally. N o r d o I feel to d a y th a t th a t low e stim a te w as in co rre ct because I re a d th a t “ o n e o u t o f every tw o y o u n g A m erican s try in g to jo in up (in th e rush o f v o lu n te e rs fo r the U n ite d S tates forces to m ee t th e B erlin crisis) is tu rn e d d ow n because o f illhealth. H e a rt disease, h y p e rte n sio n , digestion d iso rd e rs, m en ta l illness a n d physical ab ility a re rife. T een ag e girls a re n o t m uch b e tte r. H e alth a u th o ritie s a re a p p a lle d a t th e w idespread lack o f fitness. P re sid e n t K e n n e d y ’s y o u th fitn e ss adviser, M r. B u d W ilk in so n says ‘it is incre d ib le b u t th e re a re a g re at m an y A m e ric a n girls w h o have n o t th e stre n g th to h o ld a n d sw ing a ra c k e t long e n o u g h to p lay a g am e o f te n n is’.” T h is is th e p re se n t sta te o f affairs in th e m o st fa v o u re d c o u n try o n e a r th ; b u t I d id n o t in clu d e in m y e a rlie r e stim a te o f th e m a lp o stu re d , as F e ld e n k ra is h a s, all m en ta l cases as well as the physical. H ow ever, y o u yourselves k n o w from th e p a r t th a t p h y sio th e ra p y , o c c u p a tio n a l th e ra p y a n d physical e d u c a tio n , generally play in m en ta l th e ra p y the ex te n t to w hich his claim is ju stifie d . O n e th in g o f w hich we c a n rest a ssu re d is th a t fo r g e n e ra tio n s to c o m e th e re will be p len ty o f e m p lo y m e n t fo r p h y sio th e ra p ists. So fa r so g o o d b u t it is w hen h e co m es to th e c o rrective side th a t we a re left in th e a ir. T h e a lte ra tio n o f h a b itu a lly fa u lty , erect c a rria g e is, as we a re all a w are , a difficult e n te r­ prise because, w h a tev e r tec h n iq u e a im in g a t b a la n c e they a re ta u g h t, p e ople fall b a c k in to th e o n e -sid ed p o s tu ra l h a b its c o n tra c te d d u rin g infancy, c h ild h o o d a n d adolescence. T o b re a k this vicious circle F e ld e n k ra is finds different su ggestions have b een m ade. O ne th e o ry a d v o c a te s e d u c a tin g th e feet first b ecause th ey c a rry th e b o d y ; a n o th e r, m ore sensible, s ta rts w ith h e ad m o v e m e n ts ; b u t h ow ever o n e p ro c ee d s th e p ro b le m is to c au se th e u n le a rn e d p a tte rn o f b e ing b a la n ce d to feel right a n d c o n sc io u s c o n tro l o f it sup e rflu o u s. N o w I h ave as little idea as a n y o f y o u w h a t th e fu tu re will reveal as th e b e st tec h n iq u e to a d o p t fo r e n a b lin g p e o p le to b e co m e physically b a la n c e d a n d to achieve e q u a n im ity — th e R o m a n s c alled it th a t : a e q u a n im ita s — a n d so to o v e r­ c o m e th e ir psy c h o p h y sic al (o r p sy c h o -so m a tic) fe a rs; b u t I h a v e n o d o u b t t h a t re -e d u c ativ e p h ysical p ro c ed u re s a re alw ays a n e ssential a n d th a t p h y sio th e ra p ists have a n o n e ro u s a n d sp le n d id p a r t to p la y in this p ro c ess o f h u m a n ity ’s re h a b ilita tio n . I a m c o nfident to o th a t th e m ain o b jective is this a cq u isitio n o f p o ise : o f e sta b lish in g v e stib u la r b a lance in th e p e rfo rm a n c e o f all o u r a ctivities. T h a t is w hy I c on- (C ontinued on n e x t p a g e ) R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) December, 1961 P H Y S I O T H E R A P Y Page 5 Post-Graduate Course on Therapeutic Movement U N IV E R S IT Y O F C A P E T O W N — D E P A R T M E N T O F P H Y S IO T H E R A P Y f o r S.A . S O C IE T Y O F P H Y S IO T H E R A P Y O n F rid a y a n d S a tu rd a y O c to b e r 6 th a n d 7 th 1961, a very successful a n d stim u la tin g c o u rse w as h e ld a t the p h y sio th era p y S chool, U n iv e rsity o f C a p e T o w n . B oth th e U n iv e rsity S taff m em bers a n d th e B ra n ch m em bers a re to be c o n g ra tu la te d o n o rg a n is a tio n a n d s u b ­ ject m a tte r o f th e lectures a n d d e m o n s tra tio n s p ro v id e d fo r those atte n d in g . T he W elcom e w as given by th e D e an o f th e F a c u lty o f M edicine, P rof. B ro m ilo w D o w n in g , P re sid e n t o f the W estern Province B ra n ch , S .A .S .P ., w ho sh o w ed th a t he is a very g o o d frien d to P h y sio th e ra p ists a t the U n iversity o f C a p e T ow n a n d to all P h y sio th e ra p ists w h erev er they m ay be. L e c tu re s It is h o ped to p u b lish m ost o f the lectures given a t the C ourse in th is J o u rn a l w ith in th e next few m o n th s . (a) S o m e A spects o f the P hysiology o f M o v em e n t, by Prof. A. D. S tam m ers, A c tin g P ro fe sso r o f Physiology, U n i­ versity o f C a p e T ow n. (b) S o m e points on the A n a to m ic a l B a ck g ro u n d o f M o v em e n t, by Prof. L. H . W ells, P ro fe sso r o f A n a to m y , U niversity o f C a p e T ow n. (c) The Im portance o f Therapeutic M ovem ent, by P ro f. C. A llen, P ro fe sso r o f O rth o p a e d ic s , U n iversity o f C a p e T ow n. T hese learned a n d e xtrem ely in te restin g a n d e n te rta in in g lectures w ere follow ed by lectures a n d d e m o n s tra tio n s by P hysiotherapists w hich w ere all o f th e sam e h ig h s ta n d a rd . (d) Introduction to som e aspects o f Therapeutic M ovem ent, by M iss M . H . S. R o p e r, S e n io r L e c tu re r in P h y sio ­ therapy, U n iv e rsity o f C a p e T ow n. P R E S ID E N T IA L A D D R E S S (C oncludedfrom opposite page) g ra tu late the J o h a n n e s b u rg tea ch e rs o n th e ir c o lla b o ra tio n in the w o rk being d o n e by P ro fe sso r H eyns a n d in fa m ilia r­ ising them selves w ith th e p h y sio th e rp e u tic a p p lic a tio n s o f his a p p a ra tu s. O ne o f its basic im p o rta n c e s is th a t it forces in to o u r th in k ­ ing the floating a q u a tic e n v iro n m e n t o f th e h u m a n fo etu s a nd the sh o c k o f its tra n s itio n fro m a w arm liq u id to co ld a ir; from d e p endence o n the m a te rn a l b lo o d stre a m to b re a th ­ ing in o n e ’s o w n oxygen fro m th e a tm o sp h e re . B u t w h a t o f .th a t b u o yancy in space, th a t T ito v d e scribed, w h e re “ a few p r o p s o f c u rra n t ju ic e e scaped fro m its to o th p a s te tu b e a n d h ung before his face like berries. H e sc o o p e d th em u p in the cap o f th e tu b e a n d sw allow ed th e m .” S tra p p ed to his c o u c h d u rin g his 435,000 m ile jo u rn e y fo r 25 h ours 18 m in u te s ro u n d th e e a rth he sle p t b ut w oke three tim es, once to find his a rm s floating in th e a ir by his side. T o keep th em u n d e r c o n tro l he tu c k e d th em u n d e r th e straps. E ven h e fo u n d som e difficulty in o rie n ta tin g his m ovem ents b ecause o f th e u n p le a sa n t se n sa tio n s d u e to distu rb an ces in his in n e r e ar. O u r m u sc u la r m ec h an ism s w ere e la b o ra te d by n a tu re over a th o u sa n d m illion y ears n o t to be th e types o f sta tic p ainful m achines in to w h ich h u m a n society a n d its m achines have so fa r tra n s fo rm e d th e vast m a jo rity o f them . T hey were b u ilt up a g ain st th e fo rces o f g ra v ity specifically to m ake us c a p a b le o f su c h p e rfe c tio n in b a la n c in g as to float as it were in space o v e r th e su rfa ce o f th e e a rth , jo y fu lly , painlessly. W e will n o t be a b le to p ro d u c e th a t fu tu re g e neration o f p ro p e rly a d ju s te d h u m an ity , u n til th e fa c to rs th a t cause the reflex a n d c o n sc io u s a spects o f b o d y m ovem ent to conflict, instead o f to c o lla b o ra te w ith o n e a n o th e r d u rin g intra- a n d e x tra -e m b ry o n ic g ro w th b ecom e m o re generally u n d e rsto o d ; a n d th u s c a p a b le o f b e ing re p ro d u c e d corre c tly . J?.o s? w *1° w ish to u n d e rs ta n d th e o rig in o f som e o f these conflicting fa c to rs fo u n d in a d u lts will find W ilfred B a rlo w ’s (e) M o v e m e n t in W ater, by M r. K . N ic o l, M .C .S .P ., M .S .A .S .P . T h is lecture w as follow ed up n e x t day by a n excellent d e m o n s tra tio n in th e T h e ra p e u tic P o o l a t th e Princess Alice H o s p ita l, R e tre a t. P a tie n ts o f v a rio u s types w ere p re sen te d , show ing the v e rsatility o f p o o l th era p y . (f) P roprioceptive N .M .F .T . M rs. R . L ew ingdon, M .C .S .P ., B ra n ch M e m b er fro m D u r b a n gave a vivid a c c o u n t o f h e r re ce n t to u r o f C a n a d a a n d U .S .A ., a n d especially th e th re e m o n th s she sp e n t at th e V allejo c e n tre (C a lifo rn ia) le a rn in g P .N .F .T . U n fo r­ tu n a te ly th e film d e m o n s tra te d by M iss M a rg a re t K n o tt d id n o t a rriv e , b u t next m o rn in g M rs. L ew ingdon show ed the p ra c tic a l a p p lic a tio n o f these tec h n iq u es em p h a sisin g the m ost im p o rta n t facts a n d p o in tin g o u t th e difficulties to be m aste red , to achieve success. (g) D em onstrations on Therapeutic M o v em e n t D u rin g S a tu rd a y , o th e r d e m o n s tra tio n s w ere given: (i) M e ch a n ica l A id s a nd S p e cia l Techniques, by M iss R o p e r a n d S tu d e n ts o f S chool o f P h y s io th e ra p y , U niversity o f C a p e T ow n. (ii) Group M o v e m e n t d e m o n s tra tio n by M iss C. J u n a k a n d S tu d e n ts assisted by p a tie n ts a tte n d in g the c linic: (!) H em ip le g ic P a tie n ts; (2) N o n -w eig h t b e arin g fra c tu re d fem ora. T hese w ere delightful to w atch a s well as m o st in structive. T h e p a tie n ts all e n te red in to th e sp irit o f th e class a n d en jo y ed them selves trem en d o u sly vieing w ith e ac h o th e r in g am es a n d c o m p e titio n s in a p a rtic u la rly h a p p y m an n e r. T h o se a tte n d in g th is C o u rse w ere e n te rta in e d a t a C o c k ­ tail P a rty o n F rid a y e v ening to w hich th e lec tu rin g P ro ­ fessors a n d th e ir wives w ere in vited. T h is w as a g ra n d “ g e t-to g e th e r” a n d m an y va lu a b le c o n ta c ts w ere m ade. (1959) a rticle o n A n x ie ty a n d M uscle-T ension Pain a n d a n u m b e r o f th e w ritin g s to w hich he h a s referred th ere rele­ v a n t. T h o se w ho wish to delve m o re deeply in to th e d e v elo p ­ m ental a sp e c t a n d u n d e rsta n d h o w vital it is th a t e ach h u m a n b e in g sh o u ld pass th ro u g h every p h a se o f his m u sc u ­ la r g ro w th p a tte rn successfully will be im pressed by the logical c lassificatory p ro c e d u re s b ased o n th e e arly m ovem ent o f c h ild ren th a t R o b e rt J. D o m e n a n d his tea m o f a ssista n ts (J.A .M .A . 174:257-262) a d o p te d to d eal w ith c h ild ren w ith severe b ra in injuries. I t is n o t m y in te n tio n , to cover, how ever briefly, these vast fields o f physical e d u c a tio n a n d re h a b ilita tio n . T hey a re m a jo r c o n ce rn s o f every civilised c o u n try a n d th o u sa n d s o f p e o p le th e w orld over. M y aim h a s been sim ply to d ra w y o u r a tte n tio n to th e p rim a ry p a rt t h a t b a la n ce plays in the w hole p rocess. I have stressed th is v e stib u la r a spect o f all fe a r b e ca u se I feel it sh o u ld d o m in a te o u r o u tlo o k ; a n d th a t if it does, it will lead progressively to th e rem oval o f m any fears by y o u r daily activ ities; a n d so, th ro u g h th e fu tu re o f y o u r p ro fessio n , e q u a n im ity will be p ro m o te d beyond m ea su re w ith in th e R e p u b lic o f S o u th A frica. B ib l io g r a p h y Ba r l o w , W i l f r e d : A nxiety a n d M uscle -T e n sio n P ain. C h a p te r 7, British J ournal o f C linical P ractice 13: N o . 5, M ay, 339-350. D a r t , R . A ., 1946: T h e p o stu ra l a sp e c t o f m alocclusion. Jour. D ent. A ss. S . A fr . 1: 1-21. D a r t , R . A ., 1950: V o lu n ta ry m u sc u la tu re in th e h u m a n b o d y : th e d o u b le sp ira l a rra n g e m e n t. B rit. Jour. p h y s. M e d . 13: 265-268. D o m a n , R . e t al, I9 6 0 : C h ild re n w ith severe b ra in injuries. Jour. A m e r. med. A ss. 17: 257-262. F e l d e n k r a is , M ., 1949: B o d y a n d M a tu re Behaviour: A S tu d y o f A n x ie ty , S e x , G ravitation a n d Learning. L o n d o n , 167 p. R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. )