OctobeivJ95^ P H Y S I O T H E R A P Y Page Seven P art H I the authoress discribes diseases of the ratory system, pre- and post-operative physio- rcsP‘ for the surgical conditions and w h en and how treat the m edical conditions, both acute and uic A section on disorders of the nervous C '-tern which includes a chapter on lesions of inter- S. tebral discs causing sciatica and lum bar pain, is followed by one on diseases of the cardiovascular system. \liss Cash states that in the treatm ent of cardiac lisordcrs m any em inent cardiologists m ake no use o f ' p h y s io th e ra p y ; ^ l]t s|ie ciaims th at w h ilst massage "nd exercises cannot cure a cardiac condition, the ' encral musculature of the patient can, by specially graded exercises, be b uilt up w ith o u t th ro w ing undue burden on the m yocardium , so that gradually the a m o u n t of w ork to be done by the cardiac muscle is increased and the patient leaves hospital more able t° resume norm al activity. The congenital abnormalities of the heart and the' appropriate tr e a tm e n t are described. C hapter 3 of this section describes diseases o f the blood vessels and a com ­ prehensive outline of treatm ent by ^physical means is given. Part V I 011 D isorders of abdom inal viscera and peritoneum is short. To quote the o pening sentence: “Very few diseases of the abdom inal' organs are suit­ able for treatm ent by physical measures,” and only three conditions are m entioned briefly, tuberculous peritonitis, for w hich actino therapy is advocated in the absence o f active tuberculosis elsewhere, con­ stipation and visceroptosis, for w hich the appropriate treatment is outlined. The last section is one on common diseases of the skin, w hich are. treated by electrotherapy. It is to be hoped th at in the not too distant future Miss Cash w ill find time, am idst' her onerous duties as Deputy-Principal of the School of P hysiotherapy, The United H ospitals, B irm in g h a m , to w rite a com ­ panion volume on Surgical Conditions for P hysio ­ therapists, w hich she can be assured w ill receive as enthusiastic a welcome as her first volume. A .C .C . P H Y S I O T H E R A P I S T Cham ber o f M in es (S p rin g k e ll) S anato rium Applications are invited from qualified P h y sio ­ therapists (Fem ale) to carry out duties of pnysiotheraphy and, in addition, to be w illin g to be instructed in and act as R adiographer. l'he salary scale is £300 x £20 — f440 p e r a n n u m , Phis cost o f liv in g a llo w a n c e ( a t p re se n t a p p r o x i­ m ately £17 per m o n t h ) . A nnual leave of 30 days plus bonus leave of 70 days after 5 years’ service. Membership to the C ham ber of M ines P ension F u nd and Medical A id Society obligatory. m e d i c a l s u p e r i n t e n d e n t , S P R I N G K E L L S A N A T O R IU M , P .O . N O R T H R A N D , Tvl. Ultra-Sonic Waves and Treatment E D I T O R I A L O F T H E S O U T H A F R I C A N M E D I C A L J O U R N A L , 2 2 n d S E P T E M B E R , 1 9 5 1 . T H E therm ogenic effect of ultra-sonic wraves is biologically not of m uch sifnificance. M ore im ­ portan t is the property of in d u c in g hyperem ia and it has also been claim ed that these waves have almost a specific m echanical effect upon the circulation of fluid in the tissue spaces, diffusion thro ug h tissue m em branes and the chemical and structural c o nd i­ tions in the cells. I t is on the basis of these pro ­ perties th a t favourable therapeutic results have been claimed in the treatm ent of arthritic, neuritic, and fibrositic conditions. R eports have not been lacking about good subpestive results in cases of “duodenal ulcer, ab do m inal adhesions, cholycystitis . . . . and neuralgia o f the abdom inal w all.” 1 The effect of ultra-sonic therapy has been ascribed to m icro­ massage of the cells as well as an increase in the tem perature of the- tissues and to colloidal changes. W h ile there can be little doubt that under experi-, . m ental conditions these waves exercise a most p ro ­ found effect on tissues, most of the reports claim ing favourable therapeutic results tend to come from W e ste rn Europe. I n E n g lis h and A m e rican hands, the results have not been specific or unique and have not indicated- th at this form of treatm ent (w hich is not w ith o ut its dangers) represents any o advance of an y kind on any of the existing m ethods in current use. D A N G E R S : The ultra-sonic waves may, w hen directed to the brachial plexus, produce paroxysm al tachycardia a n d an gin a pectoris. A lth o u g h it has been claimed to have good results in the treatm ent of ulcers of the leg, there is the ever-present danger of m o b ilizin g regional throm bi. T he waves can also, by their action on the gonads, produce sterility. They can interfere w ith the developm ent of grow ing bones in children and place the operator of the instrum en t at risk. I t is clear, therefore, that in ­ strum ents for producing these waves m ust be re­ garded as h ig h ly dangerous. There can be no excuse for p e rm ittin g their use by lay persons and it is desirable th at even members of the medical profession should use the apparatus only under licence. A s it seems d oubtful w hether an y special therapeutic virtue is inherent in the use of u ltra ­ sonic waves and because no sound scientific case has yet been made out for g iv in g these waves any therapeuic pre-eminence or specificity, we should be m ost cim cum spect about the in tro du ctio n of these dangerous instrum ents into the U n io n and, in p a r­ ticular, their use by inexpert lay persons. W h a t ­ ever claim s are to be m ade should at this stage still be directed to the field of research rather than clinical practice. 1 Excerpta M edica, 1951, Section V I ( Internal M edicine), 5, 317. 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. )