Kneading

“ Many do not know how to do the kneading or malaxation with ease and comfort to themselves and to their patients, for, in place of working from their wrists and concentrating their energy in the muscles of their hands and fore-arms, they vigorously fix the muscles of their upper arms and shoulders, thus not only moving their own frame with every manipulation, but also that of their patients, giving to the latter a motion and sensation as if they were at sea in stormy weather. ”

“ Knead, nēd, v.t. to work and press together into a mass, as flour into dough: to operate upon in massage: to mix.—ns. Knead′er; Knead′ing-trough, a trough for kneading. [A.S. cnedan; Ice. knoða, Ger. kneten, to knead.]
Knee, nē, n. the joint between the thigh and shin bones: a piece of timber or metal like a bent knee: (Shak.) a genuflection.—v.t. (Shak.) to kneel to, to go over on one's knees.—n.pl. Knee′-breech′es, breeches extending to just below the knee, as in court-dress.—n. ”

“ Toss back the ball into this, and knead hard—always toward the centre of the mass, which should be repeatedly turned over and around, that every portion may be manipulated. Brisk and long kneading makes the pores fine and regular. ”

“ It is of the first importance that people should learn to abhor anything which is so awkward, perishable, and dirty as a hassock. They must not, however, forget, as some do, that the human body is so constituted that kneeling on the floor for any length of time is not the alternative. Such kneeling strains the joint between the foot and the leg at the point B B in the accompanying drawing. It is not a natural posture for that joint. To most people there would be the further objection that the floor must be dirty. The knee should be lifted about five inches above the floor in kneeling. ”

“ The man softly, yet awkwardly, lifted the robe, folded it back, and slowly uncovered the knee. The leg was worn away almost to skin and bone, but the knee itself was swollen with inflammation. He bathed it with some water, mixed with vinegar and herbs, then drew down the deer-skin shirt, and did the same with the child's shoulder. Both shoulder and knee bore the marks of teeth,—where a huge wildcat had made havoc—and the body had long red scratches. ”

“ Experiment 29. To show the ligamentous action of the muscles. Standing with the back fixed against a wall to steady the pelvis, the knee can be flexed so as to almost touch the abdomen. Take the same position and keep the knee rigid. When the heel has been but slightly raised a sharp pain in the back of the thigh follows any effort to carry it higher. Flexion of the leg to a right angle, increases the distance from the lines of insertion on the pelvic bones to the tuberosities of the tibia by two or three inches—an amount of stretching these muscle cannot undergo. ”

“ The knee-cap, for instance, which really belongs to the thigh, is attached to it by muscle, but to the shin-bone by a stout ligament. And so with the bones of the arm; they are connected to one another by ligaments; but to the trunk only by muscle, excepting at one end of the collar-bone.
"But this was a very significant fact. Ligament decays much more slowly than muscle, so that in a body of which the muscles had largely decayed the bones might still be held together by ligament. ”

“ When they salute a person of rank, they bend the knee in such a manner as to touch the ground with their fingers." We are shown the same thing equally well, or better, in China, where, among the specified gradations of obeisance, the third is defined as bending the knee, and the fourth as actually kneeling. ”

“ The knees should be strait and braced, and the body, though perfectly strait, not perpendicular, but inclining as far to the right as a firm position on the right leg will permit. The right arm must then be held out with the palm open, the fingers straight and close, the thumb almost as distant from them as it will go, and the flat of the hand neither horizontal nor vertical, but exactly between both. ”

“ As a bodily act of reverence, kneeling, either on one knee or on both knees, includes every kind of bowing, just as a profound bow includes a moderate bow, and therefore in such kneeling the head is not to be bowed. ”

“ Then you have to fight nature which stiffens the knee too much. You have to fight it by the use of the knee, by walking or by massage, which is not, however, so good as walking. If we respect blindly what nature does in stiffening the knee even to the exclusion of nature's other functions, such as walking, then the knee will get worse. One of the greatest improvements in the modern treatment of sprains, is that we no longer keep the [Pg 138] patient in bed and put plaster of Paris on, which makes the sprain last for months sometimes ”

“ For the knee spring a suitably protected heavy elastic web is slipped over end of the rod and adjusted from outside of leg with buckskin strings; as leg is flexed in act of walking, the rod is forced through the hickory bar, stretching the web and forcing the lower part of the leg forward in position for next step; when lower part of leg is flexed at right angles with the thigh, as in sitting, the pressure of spring is automatically released. This change simplifies the knee-joint construction, is lighter and more convenient of adjustment. ”

“ Not dwelling on the transition from descent on both knees to descent on one knee, which, less abject, comes a stage nearer the erect attitude, it will suffice to note the transition from kneeling on one knee to bending the knee. That this form of obeisance is an abridgment is well shown us by the Japanese:
"On meeting, they show respect by bending the knee; and when they wish to do unusual honor to an individual they place themselves on the knee and bow down to the ground. ”

“ BOW-LEG (Genu Varum) , a deformity characterized by separation of the knees when the ankles are in contact. Usually there is an outward curvature of both femur and tibia, with at times an interior bend of the latter bone. At birth all children are more or less bandy-legged. The child lies on its nurse’s knee with the soles of the feet facing one another; the tibiae and femora are curved outwards; and, if the limbs are extended, although the ankles are in contact, there is a distinct space between the knee-joints. During the first year of life a gradual change takes place. ”

“ The knee, when fully developed, is generally hollow, comparatively soft, gnarled, and hard to rupture, so that it has the quality of a spring that becomes more rigid as it is extended or compressed out of its normal shape. ”

“ The reason the knees are used is to be accounted for by the fact that, owing to the great length of the human leg and thigh in proportion to the length of the arm, the knee would naturally be brought to the ground, and the instep and top of the toes would be used instead of the sole and heel of the almost inflexible foot. Why the elbow should be employed instead of the hand is less easy to understand, but probably it is better suited to give support to the head and fore-part of the body. ”

“ The change in the knee is most significant. The armour plating of thicknesses has tended to disappear. The knee is usually innocent of patches and often left, in Tyrolese fashion, uncovered. The change is due to our change in style. While the foot still demanded broad holds, necessarily found at longer intervals, for its balance, the knee was constantly in requisition for an intermediate push up. While grip climbing obtained, the knee was more useful than the foot to jam with or to scrape downward against the rocks. ”

“ The knee also is formed from it as a center. But as the inside of the leg is a straight line and the outside of the leg is hollow at the knee, it follows that, for a close-fitting pants leg at the knee, the outside first requires a reduction of say three-eighths to one-half an inch, on double cloth, which again is allowed at the inside, after which the width may be reduced equally on each side, if such reduction is necessary. ”

“ A shoemaker called my attention to the baggy trousers knees observable in connection with the wearing of high-heeled boots, and said, "Elevation of the heel thrusts the knee forward." The human body should stand erect from the heels upward, but the projection of the knee makes necessary a bending forward of the whole frame, to maintain an equilibrium. This is undoubtedly one cause of the ungraceful round shoulders and poked-forward head noticeable with so many women and girls.
The shoes of men, as a rule, are not so badly constructed and worn as the shoes of women and children. ”

“ The kick could be prevented by bending the knee so as to bring the heel up to the buttock, and projecting it, when the knee caught the administering player on the leg-bone above the knee with such force as to paralyse it for a while, and it has even been known to break it. ”

“ Sprains of the knee are comparatively common as a result of sudden twisting or wrenching of the joint. In addition to the stretching or tearing of ligaments, there is usually a considerable effusion of fluid into the synovial cavity, and examination with the X-rays occasionally reveals that a portion of bone has been torn away with the ligament—sprain-fracture. The swelling fills up the hollows on either side of the patella, and extends for some distance in the synovial pouch underneath the quadriceps. ”

“ As regards treatment, a tightly fitting steel cage-like splint, which, gripping the thigh and leg, limits the movements of the knee to flexion and extension, may prove useful. But for a muscular, athletic individual the wearing of this apparatus may prove vexatious and disappointing. The only alternative is to open the joint and remove the loose cartilage. The cartilage may be found on operation to be split, torn or crumpled, and lying right across between the joint-surfaces of the bones, from which nothing but an operation could possibly have removed it. ”

“ The thigh-bone is very much longer in proportion to that of the metatarsus—the one below it—than is the case with other animals, and thus the knee is very much lower down. He has also no hock, and can thus bend his knee as completely as a human being. ”

“ The knee-joint is largely a hinge joint, but in some positions it has some rotation. It is formed by the condyles of the femur, the head of the tibia, and the patella, and has fourteen ligaments, including the ligamentum patellæ and the crucial ligaments. Its synovial sac is the largest found in any joint. Two semilunar cartilages, placed on the head of the tibia, serve to deepen the socket for the condyles, changing somewhat in shape and thickness as the joint moves. The interval between the thigh and the leg bones can be felt at the knee. ”

“ The same may be said for the markings on the bone, which indicate the presence of powerful muscles whose action is to keep the thigh straight with the back—or in other words, to keep the body erect. Below the knee are the two bones of the leg: the inner one, or shin-bone (the tibia) , is very short for the height of the animal, and the joint on its lower part, on which moves the ankle-bone, is not so deep and perfect as in man, whose weight is constantly to be borne on it whilst it is being moved in walking. ”

“ A Loose Cartilage, or a Displaced Cartilage in the Knee Joint is apt to become caught in the hinge between the thigh bone and the leg bone, and by causing a sudden stretching of the ligaments of the joint to give rise to intense pain. ”

“ When the process is continued, in about two years the nerves of the parts implicated in the bandages have become deadened, and pain ceases, the muscles below the knee have shrunk for want of use, and the feet, the front parts of which have been completely destroyed or doubled under, are reduced to mere stumps, on which locomotion is about as easy as it would be if the legs from the knees downwards were made of wood. ”

“ The parts can be immobilised by the application of a vesicant or mild blister. A week or ten days later dry friction, muscular and periarticular massage are indicated, and gentle exercise should be commenced. The same treatment may be employed in strain of the elbow joint and in strains of muscles or tendons in the neighbourhood of joints. Such lesions are, however, very rare in the ox.
STRAIN OF THE KNEE. Strain of the knee is commoner in the ox than in the horse, because of the special conformation of the knee in the ox and the mode of working under a yoke. ”

“ The knee-cap is lozenge-shaped; its superior angle projects upward, and produces a prominence at the part which corresponds to the base of the human patella, the part which is here the thickest portion of the bone. Its anterior surface is convex and rough. Its posterior surface presents two lateral articular facets, separated by a crest; this surface is in contact with the trochlea of the femur, and, as it is the internal lip of the latter which is the more developed, it results therefrom that the internal articular surface of the knee-cap is larger than the external. ”

“ The use of boots reaching to the knee, to be removed only at night, will afford immediate relief. In connection with Contractio is often found-- II. Inflatio Genu, or Bagging of the Knees of the Trousers, a disease whose symptoms are similar to those above. The patient shows an aversion to the standing posture, and, in acute cases, if the patient be compelled to stand, the head is bent and the eye fixed with painful rigidity upon the projecting blade formed at the knee of the trousers. ”

“ The side of the knee should be hollowed out, while at the calf the side seam must run outward. If the person be “bow-legged,” then the outside must receive more cloth and the inside less, if the form of the leg is to be followed; but, as a general thing, bow legs in pants should be so formed that the inside is pretty full, in order to hide such a deformity. ”

“ By elongating the thigh-piece by means of the screw, extension is kept up. Great complaint is commonly made by the patient of pain and stiffness in the knee for a long time after the treatment of broken thigh in the bent position.
There is no possibility of treating fracture of the thigh, with any satisfaction or credit, on the outside of the limb with the knee bent; however attentively the splints are placed, shortening, eversion of the foot, and deformity of the whole limb, are sure to follow. ”