Page 8 P H Y S I O T H E R A P Y September, 1966 The Jane Furse Memorial Hospital J. M c G u i r e , M. C. S .P . T h e Ja n e Fu rs e H o s p it a l is the largest Mission Hos pital, not only in the T r a n s v a a l, bu t in the whole o f S o u t h Africa. It was fo un d e d as a m em or ia l to y o u n g J a n e , only d a u g h te r o f Bish op Fur se , in 192J, a n d is situ ate d in the Re serve area o f S e k h u k h u n i la n d , which has a p o p u l a t i o n o f a b o u t 200,000 people. I f yo u are w o n d e ri n g wh er e it is, ta k e as three points o f a triangle Pi ete rsb ur g, G r o b l e rs d a l a n d L yd en b u r g , a n d the hosp it al is right in the centre. Cl im b i n g up the hill close by a n d loo king back , y ou c an see it sp re ad out over 200 acres, m an y single-storied buildings set a m id st the trees; a veritable oasis in this r a t h e r dr y c ou n try . We are o n a pla te au 4,500 feet up, a n d in every d ir ect io n th ere are ra n ge s o f hills rolling o n for miles. As yo u e nt e r the hospital gates, a sa n d y t ra c k to the left leads to “ H a r le y St r e et ” , where so m e o f the d o c t o r s a nd th eir families live. Beyond them is the farm , whi ch is a c o m pa r at iv el y new ve nture, a n d struggles agai nst difficulties because o f th e lack o f rain. De spi te this, fresh milk a n d vegetables a r e pro vi de d for pati en ts a n d staff alike. T h e hospital is a tr a i n i n g sch ool for so m e ni nety nurses a n d midwives, th ere being a large m at e rn i t y section. Th er e are general medical a n d surgical wa rd s inclu din g o rt h o p a e d ic beds, a n eye w a r d, a general ward fo r bab ies a n d a n o th e r o n e for the ol de r ch ildren. I n a se pa ra te block are the T.B. patients a nd isolation. Officially th ere are a b o u t 500 patients, b u t th ere are usually m or e. “ J a n e ” is well eq u ip p e d , having tw o thea tre s, a bu sy dispe nsa ry , X - R a y a n d l a b o r a to r y . T h e r e are ten clinics wit hin a r a d iu s o f forty-five miles a r o u n d this centre, a n d all a r e visited by a d o c t o r on ce a fortn ight. I n a d d it i o n the cal l-outs go o n d a y a n d ni ght, a nd the L a n d - R o v e r brings ba ck p a ti e n ts fro m the mo st inaces- sible places! o n t o the O . P . D . and on W e d ne sd a y s the m o th e r s queue th ere for their c ar ds befo re g oi ng to the Bab y Clinic. They c o m e early and m a k e a d a y o f it, a nd th e ba be s ar e spotlessly attired in E u r o p e a n clothe s a nd the latest plastic panties. H o w ev e r , if yo u look a little closer, y ou m ay see the odd bit o f a n im a l skin u n d e r n e a th ! I hav e a n Africa n assistant to help me, a n d she not only acts as cle ane r an d portress, but in ter pr ets in five languages! So m e pa tie nt s sp ea k Afrikaans, but I have fou nd a n ele m en ta ry knowledge o f N or t h e rn S o t h o has prov ed very useful. Because I a m the only p h ys io th era pi st here, the type of w o r k I have is varied a n d I have the full c o- o p e r a ti o n o f all the do c to rs . At the time o f wri tin g there a r e only fou r doctors here, bu t the full c o m pl e m e n t is six. T h o se pati en ts whom y ou woul d no rm all y trea t as o u t- p at ie n ts have perforce to be com e in-p atien ts as their h o m e s are so far a w a y ; a point no t a lt o g e th e r a pp rec iat ed by one city d o c to r , w h o sent a patient ba ck f r om a J o h a n n e s b u r g hospital with instructions “ to have daily injections as a n o u t - p at ie n t, as the walk will d o him g o o d . ” A s the patient had only h alf a l un g a n d lived twenty miles aw ay, it did not seem to be very practicable! On c e a m o n th a n O r t h o p a e d i c Tec hn ic ia n co m e s up from P r e t o r ia to see a n d advise o n a n y pati en ts n eed in g appliances. H e c an usually m an ag e to m ea su r e th em on e m o n t h and re tu r n with the finished article the next m o n th , o r at latest, with in eight weeks. I have a n u m b e r o f child ren to treat who are eit he r men tally affected a fte r encephalitis, o r are deaf a n d t h ere fo re d u m b , spastics, old c o nt r a c t e d polios, and little m aln u t r it i o n cases, un a b le to wa lk o r smile, w h o are sent a lo n g to j o in my “j o y a n d agility class” , as one doc tor p u t it on the bed-letter! W h e n so m e o f these children reach sch ool age th ere woul d seem to be a g ood c h anc e in the fu tu re o f getting th em a d m i t te d to a special han dic app ed school which is being built a b o u t sixty miles f r o m here. A general view o f the P hysiotheraphy departm ent. M y ow n d e p a r t m e n t was sta rte d by the late Miss Fr e re in 1946. T h e present r o o m was op e n ed in J954, a n d e q u ip p e d a n d paid for by Miss F r e r e herself. Since th en va rious ad d it i o n s have been m a d e a n d n ow I have e ve ry th ing except a n ultra -son ic mac hine. I have on e large r o o m with three cubicles, a n d a c er ta in a m o u n t o f space for exercises, a lt h o u g h it is im possible to take a large class. T h e office leads off it, a n d the d e p a r t m e n t is d e c o r a te d t h r o u g h o u t in pale green with M a rl ey tiling o n the floor. M y wi n d ow s l oo k out L e g Class. Two o f these p a tie n ts are recovering paraplegics a fte r T.B. Spines. A t t a c h e d to the ho sp it al is the Priory, the centre o f all mission w o r k carri ed o u t in this vast area . T h er e are two E u r o p e a n priests a n d on e African. I n the hospital grounds we hav e a small cha pe l where the services are held in English, b u t in the large r P a r i s h c h u r c h th ey are all held in Sotho. T h e local people have p a rti cul ar ly co lo ur fu l clothes, the w o m e n we ari ng coun tless long c o tt o n g ar me nt s, o r blankets, w r a p p e d tightly r o u n d their waists, a n d all s u r m o u n t e d by a loose s m o c ke d frock. T h e i r h ead s a n d necks a r e swathed a b o u t with usua lly a vivid pink o r or a n g e scarf, which often covers th eir faces as well, leaving only th eir eyes showing. T h e y have a great love o f b e a d w o r k a n d visiting hours so m e tim es p r o du c es a wealth o f colou r. Peo pl e ask me in mystified to n es w h a t we do up here in o u r spa re time, but I find it quite h a r d to fit in all that I want o r have to do ! We are o n e h u n d r e d a n d eighty miles from 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. ) September, 1966 P H Y S I O T H E R A P Y Page 9 Joh a n n e sb u rg a n d o n e h u n d re d a n d sixty fro m P re to ria , a n d the sixty m iles o f d irt r o a d has so im p ro v e d in th e last tw o years th a t o n e c a n g e t to P re to ria in th re e h o u rs. T h e re is a com m unal c a r b elo n g in g to th e S iste rs’ H o u s e w hich several o f us sh a re, w h ich m e a n s th a t we c a n ta k e it fo r w eek en d s or on leave. W e a re allo w e d to a c c u m u la te p u b lic h o lid a y s and fo r a n o c ca sio n al lo n g w e ek e n d it is p o ssib le to re a c h a num ber o f p laces fro m h e re like K r u g e r P a rk , L o s k o p D a m , Swaziland, o r L o u re n c o M a rq u e s . T h e re is a lib ra ry here that gets re p le n is h e d re g u la rly , several o f u s h a v e re c o rd players, th e re is a ten n is c o u rt, a n d scope fo r v a rio u s h o b b ie s ; photography, p lay -re ad in g s, S c o ttish d a n c in g a n d so o n . As you can im agine, it is a q u e stio n o f m a k in g y o u r o w n e n te r­ tainm ent, as th e re is n o c h a n c e o f g o in g ro u n d th e c o rn e r to the b ioscope! T h e n e a re st o n e is sixty m iles a w ay. T h e nurses d o so m e tim es have a film in th e ir R e c re a tio n H a ll, but it is u su a lly e a s ie r seen th a n h e a rd , a n d y o u m a y be c alled upon to w o rk th e p ro je c to r a n y w ay , a s th e re a re a m u ltitu d e of little ploys o f th is n a tu re th a t seem to n e ed d o in g ! A ll in all, the life h e re is n o t n e a rly so iso la te d as o n e m ig h t e xpect, and fo r so m e o n e w h o has h a d a c e rta in a m o u n t o f exp erien c e the post o f p h y sio th e ra p ist is a n in te re s tin g o n e , a n d y ou certainly see a v ery different side to A fric a n life. B O O K R E V I E W T HE P E R IP H E R A L N E R V O U S S Y S T E M . J. P . S chade. Publishers: E lsevier. 1966. p .p . 2 30; Illu s. 84; C h a rts 3. Price: R 7.20. This b o o k is d iv id e d in to f o u r se c tio n s, ex clu d in g a bibliography a n d index. T he in tro d u c to ry c h a p te r gives a b rie f b u t co m p re h en siv e discussion o f re c e n t d e v elo p m en ts in th e s tru c tu re o f a nerve cell, in c lu d in g e le c tro n m ic ro sc o p ic se c tio n s o f n erve tissue. Section tw o o n th e s p in a l nerves. T h e d e sc rip tio n o f th e nerve plexi is to o gen era lise d a n d la c k in g in d e ta il o n th e courses and re la tio n s fo r p h y sio th e ra p ists. T h e d ia g ra m s a re excellent, except th a t th ese c o u ld h a v e o c cu p ied a w h o le page, to a d v an tag e , in ste a d o f leaving la rg e b la n k a rea s. The clinical a p p lic a tio n a n d a p p lie d a n a to m y is g o o d . A n extremely s h o rt c h a p te r o n th e sp in a l a u to m o n ic system concludes this section. Section th ree o n th e c ra n ia l n e rv es is e x cellent, w ith clinical application a n d a p p lie d a n a to m y fo r e ach nerve. T h is se c tio n includes a s h o rt co n cise c h a p te r o n th e c ra n ia l a u to n o m ic system. T h e d ia g ra m s a re excellent. Section fo u r, th e c o m p e n d iu m , is a m o s t u seful se ction having diagram s o n th e se g m en tal d is trib u tio n o f the- sp in a l nerves, follow ed b y c h a rts sh o w in g th e se g m en tal m o to r innervation o f th e tru n k a n d lim b s. T h is, in tu r n , is fo llo w ed by diagram s sho w in g th e p o ssib le m o to r p o in ts o f th e b o d y , for electrical stim u la tio n , in c lu d in g p o in ts w h e re n e rv es a re most superficial. T h ese la tte r d ia g ra m s w o u ld h a v e b een much im proved by th e in clu sio n o f b o n y la n d m a rk s . T h e paragraph o n th e a sc e n d in g a n d d e sc en d in g sp in a l p a th w a y s is clear, concise a n d extre m e ly well illu stra te d . T h e final p a r t of the com p e n d iu m gives th e a tta c h m e n ts , n e rv e a n d seg­ mental supply, a c tio n , a n d w h e re a p p lic a b le , h o w to test th e function o f m uscles o f th e b o d y , these a re a rra n g e d in alphabetical o rd e r fo r easy reference. D e ta il is a g a in lac k in g in this p a r t a n d th e re a re a n u m b e r o f o m issio n s o f e ith e r attachm ents o r a ctio n s. The b ib liography is extre m e ly sh o rt, w h e rea s th e in d ex to subject m atter is very g o o d a n d c ro ss refe re n ce d . W ith the b o o k a re th re e c h a rts , o n e fo r e ac h m a in se c tio n o f the book. Plate I. The diagram s, o f th e d is trib u tio n o f th e p e rip h e ra l nerv es showing b o th m o to r a n d se n so ry su p p ly is well illu stra te d , b u t I fo u n d th e n u m b e rs a little c o n fu sin g initially . T h e d ia g ra m o f th e sp in a l c o rd a n d sp in a l n e rv es is v ery g o o d . P la te I I . T h e d ia g ra m s sh o w in g th e f o rm a tio n a n d d is trib u tio n o f th e c ra n ia l n e rv es is b e a u tifu lly illu stra te d . T h e b a se o f th e skull a n d b a se o f th e b r a in sh o w in g th e c ra n ia l nerv es is c ro ss re fe re n c e d to sh o w w h e re th e n e rv es leave th e skull. P la te I I I . S h o w s th e a sc e n d in g a n d d e sc en d in g tra c ts o f th e sp in a l c o rd , in c o lo u r, a t e a c h level fro m sa c ru m to cervical, a lso th e in te g ra tio n a n d in te rse g m e n ta l c o n n e c tio n s, a s well as th e p e rip h e ra l te rm in a tio n . A g a in th e d ia g ra m s a re excellent. E a c h o f th ese c h a rts c a n a lso b e u se d as tea c h in g a id s a n d w all c h a rts. T h e la y o u t o f th e b o o k is u n u s u a l in th a t th e tex t is c o n ­ fined to th e left h a n d p a g e s a n d th e re la tiv e d ia g ra m s a re on th e r ig h t h a n d pages. L ik e all “ a id s ” it h a s its s h o rtc o m in g s, b u t a s a b o o k fo r re v isio n o r q u ic k re fe re n ce it is extre m e ly g o o d , th e d ia g ra m s a n d p la te s a re su p e rb . I t is in te n d e d fo r u se by p e rso n s hav in g a k n o w le d g e o f th e s ta n d a r d te x t b o o k s o n th e su bjects c o v ere d b y th is b o o k . T h e re a re o m issio n s, fo r ex am p le, such a s o n ly th e b o n y in se rtio n o f g lu te u s m a x im u m s is given, th e re is a c h a n g e o f c o lo u r sch em e o n F ig . 75, these s h o u ld b e o b v io u s to re a d e rs, e x ce p t p o ssib ly stu d e n ts. T h e b o o k w ill m a k e a u se fu l a d d itio n to a n y m ed ic al lib ra ry , a n d q u a lified p h y s io th e ra p y s ta ff m a y find it a h a n d y easy re fe re n ce b o o k . S tu d e n ts m a y find difficulties, as th is is n o t in te n d e d to re p la c e th e s ta n d a r d tex t b o o k s , a n d a g o o d g ro u n d in g in th ese a re re q u ire d to get th e m a x im u m b enefit fro m th is ty p e o f b o o k . J. S to c k to n . For quality printing consult J. G. INCE & S O N (PTY.) LTD. • PRINTERS • STATIONERS • BOOKBINDERS • RULERS • LITHOGRAPHERS P r i n t e r s o f t h i s J o u r n a l P.O. Box 200, BOOYSENS, Transvaal Telephone 8 3 4 -4 2 0 1 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. )