September, 1965 P H Y S I O T H E R A P Y Page 17

n n O K  REVIEW

PH Y SIO T H E R A PY  IN  L E P R O SY . By M errill Mendis,
M.S.C.P. Published by John W right and Sons, Ltd.,
Bristol, England.

This book is the result o f research work undertaken by 
Mr. Mendis on a Fellowship from the W orld H ealth O rgani­
sation. There is a foreword by D r. Paul B rand, who is well 
kn ow n  as an authority on leprosy.

The first section is a concise account o f the nerve involve­
ment in leprosy, pointing out clearly those com ponents of 
the paralysis which cause most functional disability. This is 
followed by excellent chapters on the assessment o f hand 
deformities and the pre-operative prevention or correction 
o f contractures by splinting, wax baths and oil massage. 
There is an interesting section on dynamic splinting.

The chapter on re-education o f the h and following surgery 
is the most detailed in the book, and should be o f great 
interest and help to  physiotherapists in this country, where 
reconstructive surgery in leprosy is still in its early days. 
The operative procedure in each o f the more com m on tendon 
transfers is described, followed by a very explicit account 
of post-operative muscle re-education, particular emphasis 
being laid on acquiring an effective pinch-grip. D uring the 
early stages judicious splinting is recom m ended to prevent 
post-operative developm ent o f contractures and to stabilize 
certain joints until the new muscle action is sufficiently 
re-educated to  prevent imbalance. A short section a t the 
end of the chapter deals with tem poralis transfer in cases 
of lagophthalmos.

The rem ainder o f the book deals w ith involvement o f 
the lower limb. T he section on lateral popliteal nerve 
paralysis deals b o th  w ith the treatm ent o f an acute foot- 
drop and w ith pre-operative treatm ent in a non-recovering 
lesion. R e-education following tibialis posterior transfer is 
then described and mention is m ade o f general foot care.

T he m echanism  o f plantar ulceration is discussed in great 
detail, followed by chapters on the treatm ent o f ulceration 
and the construction o f various types o f shoes for patients 
with anaesthetic feet. T he final sections deal w ith the edu­
cation o f patients to  the precautions required in anaesthesia, 
and a short section on the splinting o f hands involved in 
acute leprom atous reactions.

D iagram s thro u g h o u t are ab undant and very clear.

A lthough intensity-duration curves are recom m ended 
as routine tests in all cases o f nerve involvement, no 
mention is m ade o f electrical stim ulation in lesions where 
recovery is hoped for. This should perhaps have been 
included since it has been proved o f value, particularly in 
lateral popliteal nerve palsy. Omission is also m ade of any 
reference to the use o f ultrasound in the treatm ent o f the 
acute, painful neuritis so often found w ith o r without 
paralysis, w hereas Z im m erm an* has stated ultrasound

*Zim merm an, R . N . (1961): “ U ltrasonics” , Seminar on 
Leprosy, U.S. Public H ealth Service H ospital, Carville.

to  be m ore beneficial th an  any other m odality in alleviating 
the sym ptom s o f acute neuritis in leprosy, the presence 
o f E .N .L . not being a contra-indication to its use.

This is, however, a book which should be welcomed as a 
handbook for the guidance of all physiotherapists concerned 
in the treatm ent and rehabilitation o f leprosy patients.

B O O K S R ECEIV ED  

(For Review later)

A Series o f Fellowship Theses published by William 
H einem an, M edical B ooks L td ., 23, B edford Square, 
L ondon, W .C .l, in association w ith the C hartered Society 
o f Physiotherapy.

1. Abnormal Postural Reflex Activity Caused by Brain 
Lesion, by B ertha B obath, F.C.S.P.

2. Physiotherapy in M ajor Knee Surgery, by Stella 
Saywell, F.C.S.P.

3. Faulty Posture—Its Effects and Treatm ent, by Molly 
T urner, F.C.S.P.

These m onographs will be reviewed in the next issue of 
this Journal and are obtainable through Medical D istri­
butors (Pty.) L td., Johannesburg and Cape Town.

CEN TRE F O R  SPA STIC  C H ILD R EN  

CHEY NE WALK, L O N D O N

Post-Registration Courses for Therapists, in Cerebral Palsy

Two six-week courses for Post-registration Physiothera­
pists, O ccupational Therapists an d  Speech Therapists will 
be held at this C entre during 1965.

T he starting dates for the courses will be M onday, 
January 11th, and M onday, June 14th. T he course fee 
wiU be £25.

A pplication to attend the courses should be made, in 
writing, to the Superintendent, the C entre for Spastic 
Children, 61, Cheyne W alk, L ondon, S.W.3.

ASSISTANT T O  H O N . GENERAL 

SECRETARY

I f  any m em ber know s o f anyone who w ould be suitable 
to act as a part-tim e paid assistant to  the H on. G eneral 
Secretary, please will they contact M rs. Levy, P.O. Box 
11151, Johannesburg. Phone 46-4649.

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