Keywords: ChronicBackache1034.png CHRONIC BACKACHE--REYNOLDS AND LOVETT Journal of the American Medical Association Chicago Ill 1910 REYNOLDS Edwards AND LOVETT Robert W PD Image ChronicBackache1033 png PD-old <TABLE><TR><TD> nature is expressed by the many names applied to the condition of which the most common are the following Hysterical spine Neurasthenic spine Weak back Uterine backache Irritable spine Chronic lumbago Railroad spine Relaxation of the sacroiliac joints Among the laity the condition is often attributed to kidney disease Without denying the existence of cases in which this symptom is the result of diverse causes such as actual uterine spinal or sacro-iliac disease we are inclined from the observations and experiments to be described to regard the term statie backache as more truly descriptive of the majority of these cases By which term we mean pain due to back strain incurred by an undue effort to maintain body balance under the conditions of the individual physiology <center>ESTABLISHED TREATMENT</center> If the patient is a woman and any abnormality of her uterine system can be found it is usually considered adequate reason for immediate treatment by the gynecologist If some innocuous uterine peculiarity is operated on in order to cure a backache which is dependent on an overstrain of the back muscles the results are not likely to be gratifying to the patient or to add much to the reputation of the surgeon who performs the operation So too the orthopedic surgeon who devotes months of effort with apparatus and gymnastics to the relief of back strain caused by the faulty posture originated by inflamed pelvic organs is likely also to fail Outside of the gynecologic treatment patients of either sex are treated by jackets corsets plaster strapping splints pads springs belts massage vibration gymnastics heat electricity etc The application of each one of these measures is empirical and the method of action of each is in general as little understood as the etiology of the condition for which it is used If instead of this blind work a serious attempt is made to investigate the causes of the condition and to study its mechanics it is possible that much confusion and many failures will be saved <center>EXPERIMENTAL SECTION REASON FOR PRESENT INQUIRY</center> The following experimental study which has occupied us for the past three and one-half years was undertaken because of the frequency with which one of us in gynecologic and the other in orthopedic practice met such cases of chronic backache especially in women and the study was made a joint one been use we concluded that a consideration of the subject from our two different points of view would be more likely to be of use than two pieces of work done by each of us separately No sooner had we started on our joint investigation however than we realized that neither of us had any exact comprehension of the causes or mechanism of the condition matters which were evic1ently essential to any clear comprehension or study of the subject We therefore turned to a study of the literature of the mechanics of the erect posture and found at that time little but vague statements founded mostly on accepted authority reliable than on observation of the living individual by reliable scientific methods We were therefore obliged to begin our work by formulating for ourselves methods </TD><TD> for the study of the mechanics of the maintenance of the upright position and at the outset It became evident that any such study must start with a determination of the center of gravity of the body and its relation to the supporting structures because all lines of strain and all muscular balance depend obviously on such relations and we desire here to express our indebtedness to Prof Ira N Hollis of Harvard University for advice generously given us on the mechanical side of our problem Our first two years and a half were therefore spent in a purely physiologic research at the end of Which time we had perfected an apparatus for determining the center of gravity in the erect living individual <ref>Reynolds E and Lovett R W Method of Determining the Position of the center of Gravity in Its Relation to Certain Bony Landmarks In the Erect Position Am Jour Physiol May 1 1909 <ref> Up to the time of this our contribution to physiology there had existed so far as could be learned from a study of literature no reliable method of estimating the position of the center of gravity of the body in the upright position Various loose statements as to its location are given in literature and there are a few carefully formulated attempt to determine it by a study of the masses of the body post-mortem and their relntion to each other but scarcely any two writers agree as to what the erect normal posture should be <ref> Borellius J A De Motu Animalium Lugduni Batavorum 1679 Braune W and Fischer Ueber den Schwerpunkt des menschlichen Körpers Abhandl d k Sachs Akad d Wissensch Mathphysik Klasse Leipsic 1889 xv 7 Dickinson R L The Corset; Questions of Pressure and Dispoacement New York Med Jour Nov 5 1887 Duchenne Etude physloloique sur la courbure lombo-sacrée et de l'inclination du bassin pendant la station verticale Arch gen de méd series 6 viii 534 Goldthwaite J E The Influence of Pelvic Joints on Posture Physical Education Rev June 1909 Uo\r1thwaite The UC'\atloll of rostme to Human F rticlenc ' Dee D I J09 Gerdy Détermination des levriers que forment la colonne vertébrale les fémurs et les tibias dans l'attitude vertleale Rev méd 1834 323 Horner F Ueber die Krümmung der Wirbelsaüle im aufrechten Stehen Inaug Diss Zurich 1854 Kellogg J H EXperimental Researches Relation of Dress to Pelvic Diseases of Women Tr Mich State Med Soc 1888 Kellogg J H The Relation of Static Disturbances of the Abdominal Viscera to Displacements of the Pelvic Organs Proc Internat Periodical Cong Gynec and Oblit 1892 Kohlrausch E Physik des Turnens Hof 1887 p 17 Lane W Arbuthnot Lancet London NOV 13 1909 Mayer G H Die Statik und Mechanik des menschlichen Knochengerüstes Leipsic 1873 Mosher Eliza M The Influence of Habitual Posture on the Symmetry and Health or the Body Brooklyn Med Jour July 1892 Mosso Application de la balance à l'étude de la circulation chez l'homme Arch ital de biol 1884 v 131 Parow W Studien über die physikalischen Bedingung der aufrechten Stellung und der normalen Krümmungen der Wirbelsaüle Virchows Arch f path Anat 1864 xxxi 74 Schmldl Unsere Körper 1903 p 63 Staffel F M Die menschlichen Haltungstypen und ihre Beziehung zu den Rückengratsverkümmungen Wiesbaden 1889 Taylor C Fayette Spinal irritation or the Causes of Backache among American Women New York William Wood and Co 1870; Tr Med Soe New York 1864 Weber M and E Mechanik der menschlichen Gewerkzeue Göttingeu 1836 </ref> The method in previous use had been as follows A cadaver was dismembered the center of garvity for each arm and leg the head and the trunk were separately obtained and by a formula the relation of these masses to each other in an ideal erect posture was calculated and the center of gravity of the whole body in this posture was then located therefrom From our observations we believe that the position of the center of gravity obtained in this way is misleading and untrustworthy for translation to the living because the results obtained have failed so markedly to agree with the actual position of the center of gravity in the actual erect posture as obtained by us A study of the well-known method of Borelli for determining the center of gravity in the horizontal position suggested to us our method of determining the antero- </TD></TR></TABLE> Permanent corset treatment Reynolds and Lovett - Chronic Backache |