Intermittent

INTERMITTENT (from Latin intermittere — to leave an interval). The intermittent character of a disease may depend on various causes: 1) on the development cycle of a parasite and the course of immunizing reactions (new remissions and attacks in malaria — febris intermittens — and in relapsing fever); 2) on the gradual accumulation in the organism of non-indifferent substances of non-bacterial origin (periodic attacks of gout depending on the accumulation of urate salts); 3) on the summation of stimuli capable of producing an attack only at a certain strength of impact on the nervous system (the putative mechanism of periodically occurring epileptic seizures); 4) in some cases, finally, on the fact that attacks occur only during periods of exhaustion of one or another organ on the basis of various unfavorable conditions, the so-called "periodic claudication" of organs (claudicatio intermittens organorum Grasset), by analogy with periodic claudication appearing during walking in cases of circulatory disturbance in the lower extremities. From what has been said, it is evident how enormous is the importance of correctly conducted functional treatment of intermittent conditions and how easy it is, by underestimating the functional significance of a limb as an organ of movement, to turn a worker injured by trauma into a helpless invalid. Indicators in assessing a particular treatment method could be the periods of temporary loss of working capacity and the disability group in intermittent limb conditions. Unfortunately, it must be noted that expertise has not yet developed definite scientifically grounded norms for the periods of restoration of working capacity in intermittent limb conditions, and in this matter, doctors proceed in a purely empirical way. German and Austrian sick funds, having great experience in this matter, have established norms also found empirically. From these it is evident that the results of treatment of intermittent limbs, if we speak not of individual achievements of individual traumatologists, clinics, and institutes, but of the results of mass processing of sick fund materials, are far from brilliant. According to Austrian accident statistics, in the treatment of intermittent thigh conditions with immobilizing bandages, complete restoration of working capacity occurs in only 20% of cases; in 80% of cases patients suffer from prolonged complications. The average duration of disability is determined at 7½ months. On the other hand, Wettstein, who applied functional treatment according to Zuppinger, did not have prolonged disability in analogous cases and achieved restoration of working capacity...