P h ysio th e ra p y, S e p te m b e r 1982, vol 38, no 3 73 APPARATUS NEW INNOVATION IN PULSED ELECTROMAGNETIC THERAPY The latest in n o v a t i o n in the rapid ly a dv an c in g worl d of pulsed e le ct ro -m ag ne tic t h e r a p y c om es fro m o ne o f the lea di ng c o m p a n i es in this field; E lec tr o- Me di cal Supplies ( G r e en ha m ) Limited o f Wan tage . The M E G A P U L S E t her ap y unit has been developed to give a very wide range o f pulse widths a n d repeat rates, th ereby en abling the thera pis t to e mp lo y a wider choice of t re a tm e nt s , within the kn ow n re qui re me nt s, for a variety of conditions. It will also be inv alu ab le for the c o n ti n u i n g research and clinical trials in this a re a o f tr ea tm e nt . The use o f sho rt -w a v e d i a t h e rm y as a t he ra pe ut ic t echni que was first used before 1930 but until qui te recently it was generally believed th at its sole effect was to increase blood flow in the zon e un d e r tr ea tm e n t. However, recent world wide research has indicated that by using pulses of e lec tr o- m agn eti c energy u n d e r strictly c ontrolled c o nd iti on s the n a tu ra l healing processes in living tissue are accelerated. F u r t h e r in vestigation into the effects of pulsed ele ctro­ m agne tis m shows th at it is beneficial over b o t h a rea s o f low sensitivity such as skin ulcers, po or ly vascularised a rea s and a reas co nt a in in g oste osynthesis a n d also ar eas having good vascularity. A lt h o u g h the process which ob t a i n s such results is no t yet clear, the effect a p p e a r s to be the re -p ol a ris at io n of cell m em b r an e s a n d incre ase d cell pe rm eability. It is against the b a c k g r o u n d o f the a dv anc es in recent years that the M E G A P U L S E pulsed th er a py system has been BOOK Tustin Frances (1981). Autistic states in children. Rout led ge a n d K e ga n Paul Ltd. L o n d o n , pp. 276. H a r d cover. R27,05. Frances Tu stin has had 30 years of ex perience as a child psych oth erap ist. In this bo ok she a tt e m p t s to ex pla in auti sm fro m the c hil d’s p o in t of view a n d succeeds in giving the reader a g re a t e r u n d e r s t a n d i n g of w h a t the child experiences. The b o o k co nsists o f three parts : n o r m a l a ut is m a n d the auti sm o f c h il d h o o d psychoses; psy ch od yn am ics , a nd the tr ea tm e n t o f p a th o lo gi ca l a n d clinical cases. The a u t h o r sta rts with n o r m a l pr i m a r y a u ti sm where mat ern al p r e o c c u p a t i o n with the child initially pro tec ts him from no t-se lf experiences. This serves as a t r a n s iti on stage from life in the wo m b. At this stage there is “ no recognition of objects as se p a ra t e fro m the flux o f sensa tio ns which cons tit ut e the i n f a n t ’s sense o f being.” He ex periences bodily rhythms in co n ta ct with his m o t h e r as a gl obal aw areness (breastfeeding is a n i m p o r t a n t pa rt o f this). Only as he develops a n aw ar e n e ss o f not-self does he de ve lo p a sense of self a n d se p a ra te identity. Grad uall y the child learns th at the not-self m o th e r does not satisfy him co mpletely a n d immediately. This brings fru str ati on a n d the child uses tra ns iti on al activities to ease him over this time. He b eco m es m or e ready to experience his m o th er as se pa ra te f r om him. T h r o u g h this process bo ndi ng lau nc h ed , bringing increased so phi sti cat ion to this m e th o d o f tr ea tm e nt . The M E G A P U L S E Hi-Q p a ti e n t a p p li c a t o r has been designed with an in ter n al- tu n ed circuit supplied with p ow er f ro m the ra dio freque nc y g en era tor . W hen used over the a r ea o f t r e a tm e n t it pr o du c es a s t r o n g ra d io freque nc y ele ctr o­ m agnet ic field, but w it ho ut giving the high pow er s often used previously. The wider range o f pulse widths a n d repeat rates th a t the M E G A P U L S E allows can be fu r t h e r contro ll ed by selection o f either a n o r m a l c o n ti n u o u s tr ain of pulses or g r o u p s of pulses. These g r o up s can f u rt h er be contro ll ed to deliver pulses for o n e third o f the total tr e a tm e n t time (with two th irds rest period) o r exactly vice versa. A c o m b i n a ti o n o f c o n tin ue d a p p lic at io n of the wider pulsed widths, 200 a n d 400 mic ro se conds in d u r a ti o n , and faster pulse repeat rates of 200 a n d 400 pulses pe r second can p r o d u c e an average p o w e r fro m the a p p li c a t o r to give a t her m al sen sation over the t r e a tm e n t area in so m e patients. A ppl yi ng pulses in g r o u p s reduces the t h er m al effect so t hat t h e tr e a tm e n t can be assessed wi th out co mp li cat io n f r o m its by- pr odu ct. The M E G A P U L S E th er a p y unit is a c o m p a c t , easily o p e r at ed unit, which will in tr o d u c e a new d i m e ns io n to this field of pati en t care. F o r f ur th er i n f o r m a t io n please c o n ta ct the S.A. Sole Agents, Medical D i s t r i b u to r s (Pty) Ltd, PO Box 3378, J o h a n n e s b u r g 2000. P O Box 195 C a p e T o w n 8000 a n d PO Box 5298 D u r b a n 4000. REVIEWS has develo ped between m o t h e r a n d child, a n d he can now tole rate being s e p a ra t e fro m her. If f o r a n y o f a large n u m b e r of reasons pr im a ry a u tis m is d i st ur be d a n d the infant reacts by develo pin g path ol og ica l au tis m , b o nd in g is di stu rb ed. A u t o m a t i c reactions block out aw ar e n e ss of the not-self m ot h e r , since this aw are ne ss is in tolerable to him. Au to se n su a l activities are intensified to preserve the fusion o r co nf use d fusion with his mo ther. Tu sti n describes tw o types of path ol og ica l reaction: ne gat io n a n d co nf usion. Neg ation leads to en cap su lat io n . En c a p su l a t i o n can be global as in the shell-type child w ho seems to be in a shell, d o r m a n t , as if waiting for m o re f a vou rab le co nd iti on s to start his d e v el op m en t. There can also be e n ca p su la ti o n o f segments, for instance som e o f the child’s per cep tio ns seem to be en cap su lat ed . T h re a te n in g not-self objects are b r o k e n up into segments until they can be b r o ug h t to ge th e r in a m o r e tole rable way. E nc a p su la ti on s a n d ch il d h o o d autistics are virtually the same. C o n fu si o n leads to c o n fu si on al autistic states o f which ch il d h o o d sc hi zop hr en ia is one exam ple. ' T r e a tm e n t o f these children is more difficult since there is a pa tho lo gi cal e n ta n g l e m e n t with the not-self. Self a n d not-self are in extri cably co nfused. Tu stin uses m any e x am p le s of child ren a n d their tr ea tm e n t to d e m o n s tr a t e her theories. 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. )