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The Journal of Bone & Joint Surgery: July 1932
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Eleven cases of osteomyelitis have been treated in the warm salt-water pool. Theoretically, the principles of treatment seem sound and by actual practice the method has given worth-while results. It is particularly suited to those cases where the osteomyelitic process involves the joint or is in close proximity to the joint.

This method of treatment embodies and makes use of definite well recognized principles in the treatment of infection and joint regeneration,-namely:

1. Adequate drainage and immobilization. After the acute stage absolute rest is not maintained, but after the first month the plaster cast is removed and the patient immobilized in bed by light traction, by splints, or by bivalved casts. Daily pool treatment is then started, but even this is comparative rest, since motions in the pool are performed with a minimum of effort. No effort is exerted by the patient in getting in and out of the pool, since this work is done by an overhead electric traveling hoist with the patient lying on a stretcher.

2. Past experience in the treatment of suppurative arthritis has proven the proposition that physiological stimulation of a joint is the best means of insuring maximum return of motion in a diseased joint, and a regeneration of joint, structure. This principle is made use of in the salt-water pool treatment without jeopardizing the cardinal principle of rest.

3. The salt solution being strongly hypertonic, drainage of the infected tissue is accelerated because the difference in osmotic pressure existing between the solution and the body fluids causes an outflow of the latter from the diseased area.

4. Active movement in the water avoids the production of inhibitory spasm from pain or fear of pain as is usually produced by other forms of physiotherapy and muscle reeducation movements.

5. The treatment is soothing and is enjoyed by the patient, as compared with spending months of inactivity in ill-smelling casts.

(C) 1932 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.

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