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134 GASES TLLUSTRATINQ THE TREATMENT.
Treatment.—The greatest pain was found at the places of
attachment of the muscles of the neck to the occipital bone.
There, then, I principally applied the treatment, which consisted
ui petrissage. Tlie muscles themselves I treated only very
slightly.
On the petrissage followed passive and active movements, as
in figs. 47, 48, 62.
Here it was seen that a muscle acting under resistance contracts
more forcibly i.e. the range of movement is greater—than when
it does so unimpeded.
Lastly, I made light vibrations over the occipital nerves.
The noise in the ears, the pain in front of them, and the
crackling in the joint, were treated with petrissage and frictions
over the facial and anterior auricular nerves.
XIV. TEND0-VAGINITIS.
K. K., sailor, 22 years old, came under treatment on the 12th
of December 1888. Six days previously inflammation had set
in in the tendons of the extensores primi-internodii and ossis
metacarpi pollicis. It began spontaneously. The tendons were
thickened for about 5 cm. in length, where they lie in their
sheath of the annular ligament ;
strong friction sounds on move-
ment ;
pain on touch and movement.
Dec. 14:ih. Friction sounds still present, but only in the neigh-
bourhood of the joint, absent higher up ;
pain is only felt in
the morning.
Dec. 17th. Friction sounds can nowhere be heard. Movement
also in the morning completely painless.
Dec. 18 th. Dismissed cured.
Treatment.—I gave at first petrissage ; afterwards passive
movements, with strong extension of the affected tendons ;
these
were followed by active movements under resistance for the
affected muscles.
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