Bier's Artificial Hyperemia as a Cure for Local Inflammation.

For many years a few writers have argued that the rational method of treating local inflammation is by the application of heat. Heat promotes an active flow of blood not only to the part, causing an active hyperemia, but from the part, carrying with it the products of retrograde metamorphosis.

Bier, an eminent surgeon of Bonn in Germany, observed the beneficial results of this method years ago, and began to make observations, first, in the treatment of chronic joint affections and subsequently in the treatment of other inflammations. He adopted various measures and made a wide range of observations, with the positive conclusion that an artificial hyperemia, properly induced, encouraged nature's processes in the cure of local inflammations, and was in itself a most rational method.

His conclusions now are that induced venous hyperemia is applicable to chronic inflammations, and that in acute inflammations the entire circulation is involved. The doctor uses many of the best known methods such as moist heat, dry heat as well as torsion bandages to attract the blood to the part and to keep it actively circulating in the part. This course is persisted in over a sufficient period, depending upon the character of the inflammation.

The effect produced by the artificial hyperemia is to increase the quantity of active blood in the circulation of the diseased area; is to lessen the pain; to promote elimination which in itself is very important, and to increase the mobility of stiffened joints.

Another very important result which the doctor believes he has proven, is the antiseptic influence of acute hyperemia. He believes it destroys bacterial life, and thinks he has more clearly proven this than any other influence of the remedy. His theory is, that as the leucocytes which antagonize the existence and the growth or development of bacteria, are concentrated in the parts by this hyperemia. Stimulated by the effect of the heat, they wage a more than usually active warfare against diseased germs. As a result of this, there is an arrest of suppuration; there is a greatly shortened term of febrile action; there is a rapid absorption of all other products of inflammation, and a normal restoration of the condition of the parts.

He believes also that this method assists in the breaking down and removal of the products of chronic inflammation, such as exostoses and other adventitious products. In severe cases where these factors are present, where there are bands of adhesion, as well, he has succeeded in breaking up deposits, releasing adhesions, dissolving, he believes, the products of the inflammation, and restoring motion to the parts.

The results of this course are so widely in contrast with those which are familiar, where cold is used, or where an antihyperemic condition is induced, that the superior advantages of this method are plainly apparent. This method also terminates necrosis, stops the progress of any destructive process, prevents the formation of bands of adhesion, and other restricting processes, and does not interfere with the nutrition of the part. In fact it greatly increases local nutrition, as it increases reconstructive activity and brings food to the diseased tissues.

About the only conditions to which Bier believes that this measure is not applicable is in the treatment of pulmonary consumption, where there are amyloid. changes, where there are large abscesses, and in deforming arthritis. Where there is local tubercular disease, benefits may be obtained, if the treatment is persisted in, but it often requires many months.

Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.