SURGERY VS PHYSIOTHERAPY


In conclusion I wish to make the suggestion that even a homoeopathic physician could increase his armamentarium and curative facilities if he would be willing to investigate and study the technique and therapeutic value of some of our simpler physical treatments. Most of us do not appreciate what we could do with our hands and the therapeutic value they possess.


Strictly speaking, surgery is only a group of modalities or that branch of medical science called physiotherapy, because it employs physical means in the treatment of disease and not internal medication.

Generally it can be divided into two main groups, constructive and destructive surgery. Constructive surgery is that group of operations which repairs, corrects and improves physical conditions, whether due to injuries or physical deformities. In this group may be included cleansing, suturing and dressing wounds of all kinds; setting fractured bones and correcting deformities; and repair of external and internal injuries, whether caused by childbirth, disease or accidents.

The destructive group consists of operations for the removal of part or parts of the body, whether internal organs or external parts. It cannot be considered curative in the strict meaning of the word, because it does not remove the cause of the disease, only the end products of diseased organs or other parts of the body.

Constructive surgery is always beneficial to the patient and every good homoeopathic physician should recognize the value and importance of this form of treatment whenever he deals with patients who may be in need of it.

The destructive branch, on the other hand, should not be used to the extent it is today. Although recognizing the necessity of using this form of surgery in some cases, yet I do not hesitate to state that a great percentage of modern destructive surgery could be avoided if surgeons and physicians of all schools possessed a better working knowledge of the therapeutic value of simple physical treatments in combination with proper diet.

Of course, the homoeopathic physician who understands the range of action as well as the correct use of the internal remedy has the advantage of physicians of other schools, but even he may be obliged to call in the service of destructive surgery to remove a diseased organ or a part of a body that cannot be saved. But if he would know how to use simple physical treatments he may save a still greater number of his so-called surgical cases from the surgeon’s knife.

The main object of this paper is to point out the therapeutic value of physical treatments and not to discuss ordinary surgical procedure to any length, hence I shall not take your time to go further into this subject. But I wish to invite your attention to the discussion of a few of the simpler physiotherapy modalities that are easily mastered and can be applied in the office of a general practitioner of the homoeopathic school.

In discussing physiotherapy and its therapeutic value before a body of homoeopathic physicians, the question naturally arises: Is there a sound anatomical and physiological base in the human constitution for physical treatments? Do these treatments actually have a curative value or only a psychological effect, making the patient think he is getting something more for his money than just a few sweet powders or tablets; and do simple physical treatments suppress the disease symptoms and interfere with the action of potentized medicine?.

Before attempting to answer these questions I want to define what is usually understood by physical therapy. This branch of medical science includes many groups of modalities, each one having an entirely different physiological action and used for different therapeutic purposes.

Of course, many of these modalities may be somewhat similar in nature and overlap each other in physiological action and therapeutic effect, nevertheless the various groups must be considered individually as to their physiological action and their therapeutic value.

The following are the most commonly used modalities of this branch of medicine: Hydrotherapy, which includes the use of water in various ways for therapeutic purposes. Heliotherapy, which includes the use of heat and light rays for their therapeutic effect. Electrotherapy, which takes in all the various electrical modalities and therapeutic usage. Manual therapy, which includes all forms of manual manipulations of the organs and structures of the body by the operator’s hands. Of these osteopathy, chiropractic and medical gymnastics are the best known and the most generally used ones. Of course, osteopathy and chiropractics claim to be distinct systems of medicines in themselves and absolutely independent of all other forms of treatments and medications.

But when properly understood in connection with other physical modalities and forms of treatment they can only be considered as part of manual therapy. Medical gymnastics, which include massage and active movements either by the patient or the operator, does not claim the distinction of being a separate system of medicine, but when properly understood and applied ranks highly and compares favorably with either osteopathy or chiropractic and can be more readily mastered by the physician.

To physiotherapy should also be added to a new modality, that of colonic therapy, of which modern colonic irrigation is of utmost value and service in the treatment of many chronic toxic disorders and diseases.

Attempting to answer the question as to whether physical treatments have a sound base in the anatomy and physiology of the body and whether physical treatments suppress symptoms or interfere with the action of potentized medicine, in an intelligent manner from the standpoint of a homoeopathic physician, I want first to discuss the “set-up” of a human being.

It is essential to have a definite concept of what man is vitally and physically, hence I will start with the axiomatic truth that man is primarily and essentially a vital living organism as well as a perfect physical mechanism. Hence, there is a vital motive living plane and a physical and mechanical one in every human being.

The vital power or the life energy, or life force, as the homoeopath calls it, furnished the body with the motive impulse, the energy or “spark of life,” which animates and makes the cells, organs and structure a living being and keeps the physical machinery going, and controlling all the functions of the body through nerve impulses. This is similar to the way electrical energy from the battery furnishes the life spark to the motor in an automobile; but without clean gas, perfect machinery and an absolutely well balanced automobile it will not function normally or operate smoothly on the road.

The same principal applies to the human body; the life energy or the vital force is absolutely essential to the life and activity of the body, but without a perfect mechanism and well balanced adjustment between the various organs and parts of the body, the body could not express normal activity as a perfect human being.

This is an important fact to remember particularly for homoeopathic physicians who have the impression and claim that the internal remedy when properly administered will accomplish almost anything in restoring the human body to normalcy even short of pulling teeth or setting bones.

There is a vital plane on which potentized medicine acts and by restoring the life energy to normal activity this is able to resume full charge of organs that may be inflamed, distorted or dysfunctioning. Mechanical laws operate on the physical plane and do not interfere with the action of the life force when the body is so adjusted that there is no friction or irritation or disturbed balance between organs or parts of the body.

We cannot ignore the fact that the human body is not only a vital organism, animated and controlled by a life force from within, but also a perfect mechanism, designed and built on correct engineering principles. Every part and every organ is so constructed and interrelated to other parts and organs that there is no friction or irritation between them in a normal, healthy functioning body. When he machinery of the body runs smoothly a person is not conscious of organs or parts of himself.

It is only when his head is aching, or his stomach is painful, or when his finger is injured that he becomes conscious of these various organs or parts. It is, therefore, important that the physician should understand not only the life function of the vital plane of life, but also the delicate and complicated machinery of the body and the interrelated functioning between the various organs and parts, as well as the many reflex symptoms the body is subject to.

Let us now consider how the average civilized man treats and takes care of the wonderful machinery he possesses in his body.

Modern civilized life is entirely different from what it was even a few decades ago. Man seems to become more reckless and indifferent to the needs and care of his body. Outwardly he may have progressed in sanitation and other preventive disease measures, but in reality he lives worse than he did in primitive times.

Oh yes, he keeps his body clean on the outside, he dresses well, in fact a little too well and heavy at times, and he may live in clean sanitary quarters, but outside of that he violates practically every law of health and hygiene in his modes and habits of eating and living.

Man eats and drinks whatever he likes without the slightest regard for the nutritive quality of the food, whether it contains the elements the body needs for proper nutrition and maintenance in health. His drinks are either bad concoctions, too hot or too cold, or they contain drugs or alcoholic stimulants; he turns his mouth, nose, throat and lungs into a chimney for burning up tons of tobacco every year, and he breathes air polluted with smoke, carbon monoxide and other poisonous gases.

In his daily work and occupation he is often subjected to hardships and dangers of all kinds, to undue strain, to jars and physical punishment; his occupation may require abnormal postures

and distortion of the body; and he is exposed to dangers, to accidents, and to injuries of various degrees and severity in these times of speed and machines.

It is, therefore, no wonder that the delicate balance and adjustment between structures and organs of the body may become disturbed and deranged. This condition may not affect or disturb the vital activity on the plane of the life force, but it will affect the normal functioning of organs, and it may cause local pressure and reflex symptoms to distal organs and parts. The bony frame may get out of plumb, parts and organs may become displaced and lose their interrelated functioning ability; and there may be pressure on nerves or blood vessels, causing muscular spasm, congestion and pain.

Such complaints and symptoms are due to mechanical derangements and can one should be corrected by physical means. On the other hand, if not corrected in time they may lead to serious disorders and diseases which ultimately require the service of destructive surgery. Of course, I am aware of the fact that we have in the homoeopathic practice special remedies useful in disorders due to trauma and mechanical injuries; but this does not change the fact that simple physical treatments would facilitate and hasten the cure of these conditions.

This discussion of modern man and his modes and habits of living has established, I think, a sound basis for the usefulness and importance of simple physical therapy in the treatment and care of disorders and diseases, particularly those caused by traumatism.

Such simple physical treatments as are found in hydrotherapy, in the application of infrared hear or radiant light or the manual manipulation of the tissues and structures of the body judiciously and skillfully applied cannot and do not interfere with the action of the homoeopathic remedy, nor do they cause suppression of symptoms. On the other hand, I am fully convinced from studies and personal experience extending over a period of many years, that such treatments assist the action of the internal remedy. In the class of simple physical treatments I do not include such modalities or x-rays or radium. These modalities go deeper into the human body and may change the vibratory activity of the normal body, and hence interfere with the operation of the vital forces of the body.

To be able to recognize abnormal mechanical conditions of the body, it is essential that the physician should not only understand the normal anatomical structures, and interrelated functions of the body but he should also understand distal and reflex symptoms caused by pressure or irritation to a part of organ of the body distal from the seat of pain or a dysfunctioning organ, otherwise he may be badly misled in the diagnosis and the treatment of the condition. None is more difficult to understand and interpret correctly than the effect of reflex symptoms on distal parts or organs.

For instance, a patient may complain of some heart symptoms; the heart in itself may be perfectly sound but a loaded and inactive colon or some disturbances of the digestive organs may cause the heart symptom. If the physician should be misled to treat the heart either by a heart remedy or otherwise and ignore or neglect the condition of the loaded colon or other digestive organs he certainly would not obtain the result he expects from his remedy or any other form of heart treatment.

Many good homoeopathic physicians and surgeons who have not investigated or studied the therapeutic value of physical treatment may be inclined to the opinion that these treatments are useless and can in no sense be substituted for surgical interference in cases where surgery seems indicated. To these I wish to say, and say it modestly but emphatically: simple physical treatments when properly understood and applied do not interfere with the action of the remedy but have marked therapeutic value in the treatment of many conditions particularly of a mechanical or traumatic nature and can be safely substituted for surgery in many conditions.

But it is important that the physician understands the physiological action of the treatment as well as its therapeutic value. He must know what a treatment will accomplish and what it will not do, otherwise it would not be safe to substitute them for surgery. Of course, in making this statement I recognize the fact that this class of treatments has limitations and that the physician will meet many cases in his practice where surgery is the only treatment, and when such is the it is important that he shall be able to recognize this fact.

To apply these principles in the treatment of a few diseases generally considered surgical, let us see what can be accomplished.

Acute or chronic appendicitis is generally treated surgically, not only by “old school” surgeons but by many good homoeopathic physicians and surgeons.

Personally, I do not see many cases of acute appendicitis since I discontinued general practice, but I see a few and a great many patients suffering from chronic appendicitis and some of these when they may have an acute attack. Some of these chronic patients refuse to employ surgery and they come to me because they have heard that I treat this condition or disease with so-called simple natural treatments.

How do I treat these cases? Usually an “old school” doctor has diagnosed the case before the patient comes to me and, of course, I always put the patient through a physical examination before starting the treatment. Either my diagnosis verifies the former one or I may find the diagnosis to be incorrect. If the patient is able to come to the office I begin the treatments by applying infrared rays or heat to the abdomen.

This relieves the pain by relaxing the spastic condition of the abdominal muscles and increases the circulation in the deeper tissues as well as relieving the general nerve tension of the patient. The next step is a colonic irrigation, and this is administered in such a way that no water or solution is forced up into the colon, which might push gas and other debris towards the appendiceal region. The entire colon from the rectum to the caecum is irrigated and cleaned out gently but thoroughly.

This will relieve the pressure and distension of the large intestine and permit gas to pass out freely. This treatment is repeated daily if possible until all the symptoms have disappeared. All food is withdrawn, but fresh grapefruit juice diluted with hot or cold water is administered, a glassful every hour or two, particularly if the patient has temperature.

If the patient cannot come to the office or to my private hospital but has to be treated at home, the procedure is quite similar except that of using colonic irrigations and infrared heat, hot abdominal compresses or so-called abdominal packs are used. If I can get hold of a nurse who is equipped and trained to give colonic irrigation at the bedside. I always call her in; but if she is not to be had the nurse in charge is instructed to give small sectional enemas, one after the other, until a fairly clean bowel has been obtained.

In giving enemas, however, it is very important that small quantities are give not a time, not more than perhaps 4, or 6, or 8 ounces, but after this has been expelled another enema of the same quantity is used. This may be repeated three or four times until the entire colon is cleaned out. But it must always be borne in mind not to push up gas or fecal debris or cause distention of the abdomen. The feeding regime is similar to the one give to office patients.

Of course, I always take the symptoms carefully before beginning the treatment and a remedy is prescribed.

Under this regime of treatment the patient usually recovers in a few days, and if he is willing to continue colonic irrigations once or twice a week for an indefinite time and to have his diet adjusted to his physical needs, the absolute cure of chronic appendicitis is always certain.

Of course, there are always exceptions to this rule and sometimes I meet patients that must be referred to the surgeon for the removal of the offending organ.

These principles and this form of physical treatments with some modifications to meet the individual need of each patient can be applied satisfactorily and successfully in the treatment of numerous acute and chronic disorders, such as cholecystitis, renal colic and pyelitis, gastric and duodenal ulcers and even cancer of the digestive system may be treated successfully in this manner. Of course, it is understood that the diet must be adjusted to meet the individual need and condition of each patient.

In conclusion I wish to make the suggestion that even a homoeopathic physician could increase his armamentarium and curative facilities if he would be willing to investigate and study the technique and therapeutic value of some of our simpler physical treatments. Most of us do not appreciate what we could do with our hands and the therapeutic value they possess.

We may smile at osteopathy; we may ridicule and condemn chiropractic, and we many think that massage and medical gymnastics have no real value except that of a little “soothing rubbing”; but in maintaining such an attitude we may not only lose a great many patients but fail to make use of all the good useful and harmless means that a good conscientious and all- around physician should have at his disposal.

Of course, in this society of the I.H.A. there may be some who are such perfect masters of homoeopathic prescribing that they do not need the assistance of any other means in treating and curing their patients; but the great rank and file of honest and hard working homoeopathic physicians may not always be able to find the absolute similar remedy and they would be greatly assisted by adding a few physiotherapy apparatus to their office equipment.

NEW YORK, N.Y.

DISCUSSION.

DR. BRYANT: The reason I was particularly anxious to have Dr. Almfelt prepare a paper was due to some articles I had read by Kovac. Kovac probably has the best book on physiotherapy on the market today. He made the statement that you are not treating disease locally as such, but that these treatments had a specific effect upon the autonomic nervous system and did a great deal to create a balance in the autonomic nervous system, which I think is quite evident from Dr. Almfelt’s paper.

DR. KAPLOWE: Dr. Almfelt has very well presented a more or less difficult subject–difficult when we view it in the light that it is sometimes hard to reconcile homoeopathy and physiotherapy and, I might even say, other therapy.

Even though Dr. Almfelt considers himself a physiotherapist, the typical physiotherapist looking upon himself more or less as a treater of disease by mechanics, Dr. Almfelt goes further than that and realizes that even though the human body functions as a mechanical apparatus, it nevertheless is governed by a dynamic or vital force which rules supreme, in the words of Hahnemann. When a physiotherapist has that conception, he cannot go wrong.

Dr. Almfelt, what remedies have you used mainly in cases where there is gangrenous appendicitis with local peritonitis?.

DR. ALMFELT: I haven’t had any such cases for a good many years. I do not think I would attempt to treat them. I would turn them over to the surgeon. They would be a little bit too dangerous. The remedy would be whatever the symptoms would indicate.

I am basically a homoeopathic physician; please don’t forget that, gentlemen. I am not trying to be a physiotherapist, I only use it as an adjunct in a practice that deals largely with chronic disease.

DR. WAFFENSMITH: Looking back, I think we will agree that had the medical profession take cognizance of homoeopathy, also the various forms of physical therapy, and incorporated them in the college curriculum, many difficulties would have been avoided, which may lead to the ultimate disruption of the medical profession as we understand it today.

Gustavus A. Almfelt
Gustavus A. Almfelt, MD