Krusen, Frank H

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Loma Linda University

Medical Arts and Sciences: A Scientific Journal of the College ofMedical EvangelistsVolume 1 | Number 2 Article 27-1947Physical Medicine and Medical EducationFrank H. KrusenUniversity of MinnesotaFollow this and additional works at: http://scholarsrepository.llu.edu/medartssciencesPart of the Medical Education CommonsThis Editorial is brought to you for free and open access by TheScholarsRepository@LLU: Digital Archive of Research, Scholarship & Creative Works.It has been accepted for inclusion in Medical Arts and Sciences: A Scientific Journal of the College of Medical Evangelists by an authorizedadministrator of TheScholarsRepository@LLU: Digital Archive of Research, Scholarship & Creative Works. For more information, please contactscholarsrepository@llu.edu.Recommended CitationKrusen, Frank H. (1947) "Physical Medicine and Medical Education," Medical Arts and Sciences: A Scientific Journal of the College ofMedical Evangelists: Vol. 1: No. 2, Article 2.Available at: http://scholarsrepository.llu.edu/medartssciences/vol1/iss2/2EDITORIAL PHYSICAL MEDICINE AND MEDICAL EDUCATION FRANK H . KRU EN, M.D. * Physical medicine includes the employment of the physical and other effective diagnostic and therapeutic properties of light, heat, cold , water, electr icity, massage, manipulation, exer-cise, and mechanical devices for diagnosis and for physical and occupational therapy and physical r ehabii itation. Occupational therapy has been defined as "medically prescribed ac-tivity (other than gymnastic) with a remedial objective. " Physical reconditioning is the pro-cedure followed in the prevention of physio-logic r etrogression during convalescence, and it is directed toward the restoration of full strength and stamina to convalescent patients. Rehabilitation includes the employment of all forms of physical medicine in _conjunction with psychosocial adjustment and vocational retraining in an attempt to achieve the maxi-mal function and adjustmen.t of the patient and to prepare him physically, mentally, socially, and vocationally for the fullest pos-sible life compatible with his abilities and dis-abilities. It is gratifying to note that medical educa-tors finally are beginning to give serious atten-tion to the developm nt of tea hing and re-search in the field of physical medicine. Dr. D. Baily Calvin, dean of the University of Te as School of Medicine, wrote recently: "In the field of phy ics as related to phy ical medicine * Professor of Physical Medicine, M ayo Foundation, University of Minnesota and Head of the Section on Physical Medicine, Mayo Clinic . 34 and physiological chemistry, great advance-ments have been made .... If health is to be construed as normal equilibrium, with proper function in all organs doing their job in proper manner, then disease must be considered as a departure from dynamic equilibrium. The need, therefore, is for the physician to serve as a health engineer, an analyst whose function is to re-adjust the equilibria of the body and bring them back into normal hqmeostatic bal-ance. " This is exactly the approach of the phy-sician specializing in physical medicine who devotes great attention to dynamic phy ical reconditioning, to the employment of physical procedures for analysis of disorders of function and to the application of physical agents for restoration or maintenance of a normal or nearly normal physiologic state. In an article entitled "Transition in medi-cal education," Dr. Alan Gregg, director of the Medical Science Division of the R ocke-feller Foundation , observed that "duri1w the past seventy-five or eighty years, one of the most significant efforts of medicine ha di-rected itself to finding the cause of disea e. " He pointed out that this " preoccupation with the cause of disease has greatly influenced medical education." He added that "etiology became, as it were, the husband of diagnosis and the father of treatment. " This led Greem- to the conclusion that " preoccupation with the causation or etiology of di ease all too often (Continued on page 51 ) Medical Arts and Sciences 51 are capable of producing definite changes in body chemistry, accompanied by disturbing symptoms. The idea that the changes must always be transient seems to be implied in many reports bearing on the subject. This is not reasonable, and it is likely that as our knowledge of clinical correlations accumu-lates, it will be evident that disturbances of respiratory rhythm continued over a long time result in certain irreversible alterations in the nervous system, both focal and diffuse. R EFERE CES Barker, L F ., and Sprunt, T. P. : pontaneous attack of Letan during a paroxy m of hyperpnea in a p ychoneurotic patient convale cent from encephaliti , Endocrinology 6:1 -15 (Jan.) 1922. Be t, C. H ., and Taylor, . B.: The phy iological basi s for medical practice, Baltimore, William · Wilkins, Pub-Ii her, eel. 4, 1945. Bridge, E. M.; Living ton, S.; and ietze, C.: Breath-holding pell ; their re lation hip to syncope, convulsion and other phenomena, J. Pediat. 23:539-561 (Nov.) 1943. Collip, ]. B., and Backus, P. L.: The effect of prolonged hyperpnea on the carbon dioxide combining power of the pla ma , the carbon dioxide tension of alveolar air, and the excretion of acid and basic phosphate by the kidney, Am. J. Phy iol. 51:56 -579 (April 1) 1920. Corwin, W., and Barry, H. : Re piratory plateaux in day dreaming and in chizophrenia, Am. J. Psychiat. 97: 308-31. (Sep t.) 1940. Dawson, P. M.: n historical sketch of the Val ·alva ex-periment, Bull. Hist. Med. 14:295-320 (Oct.) 1943. Fine-inger, J. E.: The pirogram in certain psychiatric di orders, Am. ]. P ychiat. 100: 159-169 (Sept.) 1943. Grant, B. , and Goldman, A.: A tudy of forced respira-tion ; e ·perimental production of tetany, Am. J. Physiol. 52:209-232 (June 1) 1920. Heppen tall , M. E.: The relation between the effect of the blood sugar levels and hyperventilation on the electroencephalogram, J. eurol. , eurosurg., & P ychiat. 7:112-11 8 (July-Oct.) 1944. Nielsen , J. M. , and Roth, P .: Clinical spirography; piro-gram and their ignificance, rch. Int. Med. 43:132-138 (Jan.) 1929. Stead, E. A. , Jr. , and Warren , J. W.: Clinical ignificance of hyperventilation ; role of hyperventilation in produc-tion , diagnosi and treatment of certain anxiety ymptom , Am. J. 1. Sc. 206:183- 190 (Aug.) 1943. Thompson , W. P .: The Electrocardiogram in the H yper-venti lation Syndrome, m. Heart J . 25:372-390 (March) 1943. PHYSICAL MEDICINE AND MEDICAL EDUCATION (Continued from jJage 34) ecl ip es th Ii ht that might com from a tudy of the d nami of th di ea proce ." H added, "W tak u h a primar on ern for the cause a perfe tl y natural. I wonder if w don't exclud th reby me oth r very impor-tant a pe t f di a e? ... Witn th mgu-lar fre hn f Howard Ru k' idea upon th po sibiliti of int lligent convalescent care . . .. If we had car d a mu h for therapy a for etioloo· , , hould ha littl e to learn from Ru k, in t ad of mu h." To the ph ician who i int re ted in phy i-cal medi in , it i pl a in to ob er e that medi al du ator hav ing the road vision of Calvin and reo·g fore e advan e and tran i-tion in m di al ducation whi h indi ate a di er ion f inter t of m di al clucator from their preoccupation with etiol gy and an acl-van ement into a tag in whi h therapy begin to a ume it rightful place in medi al education. It i rea urino-, mor ver, to per-ceive that proper attention to the treatm nt of the patient a a per on and a a whole i begin-ning to re ei e riou con ideration. er-tainl y, the importanc of the maintenanc of dynamic quilibrium will be om mor and more appar nt a thi nev trend de elop and just a certainly, phy ical medicin will on-tinu to fora- to th front a thi trend be-om more ident. REFERE E Calvin, D . B.: Re ent advances in medicine and their elf ct on premedi a l needs. J . A. Am . M d. oil. 22:82-89 (Mar. ) 1947. Gregg, Alan: Transition in medical education . J. A. Am. Med . Coll. 22 :226-232 (Jul y) 1947. 

Physical Medicine and Medical Education

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Physical Medicine and Medical Education

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