American physician William Hammond (1828-1900) perfected his own dynamometer in 1891.
American physician George Wells Fitz (1860-1934) set up the first research laboratory for physical education at Harvard's Lawrence Scientific School. Under his leadership experiments were carried out about motion effects on the human body.
Together with French Professor Chemistry Maurice Hanriot (1854-1933), Parisian physiologist Charles Robert Richet (1850-1936) developed a method for determining the respiratory exchange, with which both oxygen consumption and carbon dioxide production were measured. For this purpose three similar large 'wet-gas' meters were used, one for the inhaled air, the second for the exhaled air and the third for the exhaled air after absorption of the CO2 in an adapted absorber. The measured difference between the second and third meters showed the amount of carbon dioxide eliminated during a certain time.
The method of Hanriot and Richet was not generally accepted, because gas meters caused specific errors, which could be difficult or even impossible to prevent in the arrangement described.
In Leipzig, German Professor of Physiology Carl Friedrich Wilhelm Ludwig (1816-1895) started the 'Physiological Institute', which focused on histology, physiological chemistry and the study of physiological problems. For this he developed many innovative devices, some of which are shown below.
Respirator Respirator for rabbits
Mercury pump with 6 artificial vessels Sphygmograph
British physiologists William Bayliss (1860-1924) and Edward Starling (1866-1927) of the University College London improved the capillary electrometer from Sanderson and Page. They showed a tri-phasic variation that accompanies each heartbeat. These deflections were later called P, QRS and T. They also showed a delay of about 0.13 seconds between arterial stimulation and ventricular depolarisation, which was later called the PR interval.
In 1891, German physiologist Adolf Fick (1829-1901) described a simple, calibrated and mechanically braked Ergometer, in which the test person had to turn a steel wheel over which a brake band ran.
This was kept elastic by a second band with a metal spring. When the wheel was rotated, both belts braked the rotational movements. The operation of the brake corresponded to the spring tension expressed in Kilopound (Kp).
During his assistantship in the laboratory of French Professor of Physiology Etienne-Jules Marey (1830-1904), French photographer, inventor and gymnast George Demeny (1850-1917) developed the 'phonoscope', with which he could record images and sound.
Three years later he developed the 'chronophotographe' with which he could capture a series of images on photo. Together with Demeny, Marey used the 'chronophotographe' to study the movement of many athletes during the 1900 Olympics in Paris. Demeny later sold his rights to the 'chronophotographe' to his compatriot Leon Gaumont (1864-1946), who is called the pioneer of cinema. In 1903 Demeny founded the 'Cour supérieur d'éducation physique' in Paris, a school for sports and medical training.
After publishing 'Le traitement par l'électricité et le massage' two years earlier, French physician A. Sigismond Weber published the book 'Traité de la massothérapie', in which the famous French surgeon Jules-Emile Péan (1830-1898) (photo) wrote the preface.
It was one of the most important works on therapeutic massage, in which the full techniques and theories were discussed about the use of massage in Surgery, Gynecology and Medicine, embellished with a whole series of illustrations.
German physician Leopold Ewer (1849-1909) was assistant surgeon in the military hospitals of Berlin and Karlsruhe during the Franco-German war. In 1874 he started a practice in Berlin, where he soon became an expert in massage and orthopedics. Ewer wrote in his book 'Cursus der Massage mit Einschluss der Heilgymnastik' from 1892 that he was the first physician to introduce the massage in Berlin in 1882. He complained about the mistrust of most of his colleagues in relation to this new therapy, despite the 'warm words' of renowned doctors. He also mentioned that the senior army doctors had to teach the massage on the army horses before they took their exam. He is also the author of 'Heinrich von Rantzau's Buch über die Erhaltung der Gesundheit' (1891), 'Leibesübungen und Wettkämpfe im Alten Griechenland und Rom' (1896); 'Indikationen und Technik der Bauchmassage' (1901) 'Der Bau des Menschlichen Körpers, for Masseurs Bearbeitet' (1901) and 'Gymnastik für Aerzte und Studirende' (1901) ..
German physiologist Max Rubner (1854-1932) developed an open-circuit respiratory calorimeter in which heat and respiration proved to be equivalent.
At the three-walled respiration chamber, the outer water jacket acted as insulation. Air was collected in the middle room, the body heat of the animal in the inner room. Expansion of the air volume caused by the addition of body heat was measured with spirometers that were visibly positioned on the parcel shelf. A carbon dioxide absorption train of the Voit type is visible on the left in the background and ensured the simultaneous measurement of the CO2.
The respiratory calorimetry peaked with the calorimeter of German-American chemist Wilbur Atwater (1844-1907).
The device was built according to the model of Henri Regnault (1810-1878) and Jules Reiset (1818-1896), a closed circuit for measuring body heat, CO2 and O2 with recirculation of the air. At the top you can see a detail of the layout of the laboratory. The isolated respiration room had a cold water battery to absorb the body heat of the test person. The photo shows the breathing train with the room in the background. The large canisters are on the shelf and at both ends are the dry-vessels.
American physiologist Francis G. Benedict (1870-1957) noted that ten technicians were needed for studies with this room and that this would take several days.
That is why he developed the device above as a replacement for the complicated, time-consuming and labor-intensive experiments with the respiratory calorimeter that until then were the gold standard for metabolic measurements with mouth or nose tubes.
It was a portable device that gave results within twenty minutes, but American physiologist Graham Lusk (1866-1932) discovered that an air leak occurred when the device was moved.
Croatian-American inventor Nikola Tesla (1856-1943) discovered the high-frequency currents. The 'Tesla streams' in Medicine are named after him.
French Professor of Medicine Jacques-Arsène d'Arsonval (1851-1940), a pupil of the great French physiologist Claude Bernard (1813-1878), was a pioneer of electrical therapy, which he introduced in Medicine in 1892.
In 1893, German orthopedic surgeon Albert Hoffa (1859-1907) published his popular book 'Technike der Massage'. In 1886 he opened a private clinic for orthopedics, physiotherapy and massage in Würzburg, and in 1895 he became an associate professor at the University of Würzburg. In 1902 he succeeded Julius Wolff (1836-1902) in Berlin as head of department of the Department of Orthopedics. Hoffa is remembered for his operations of hip dislocations as well as for development of a system of massage therapy (Hoffa system). In 1892 he founded the 'Zeitschrift für orthopädische Chirurgie' and in 1901 he was one of the founders of the German Society for Orthopedic Surgery.
During a meeting of the Dutch Medical Association, Dutch physician Willem Einthoven (1860-1927) introduced the term 'electrocardiogram'.
At the turn of the century, German sports physician and physiologist Ferdinand August Schmidt (1852-1929) published pioneering works on sports medicine. 'Die Leibesübungen nach ihrem körperlichen Übungswert' appeared in 1893, and between 1899 and 1930 'Unser Körper-Handbuch der Anatomie' and 'Physiologie und Hygiene der Leibesübungen' was printed in eight editions.
American physician John Harvey Kellogg (1852-1943) wanted to measure his own strength to see if there was any progress in his health treatment.
He invented a dynamometer filled with mercury, water and oil that could be adjusted to measure the strength of the most important muscle groups. With this device he made a normative database of four hundred healthy men and women. His article from 1893 showed that he was able to test 28 different muscle groups.
References to sports medicine can already be found in the description of the modern 'therapeutic gymnastics' of the 19th century. In the 'Encyklopädie des Gesamten Turnwesens' from 1894 by German gymnast pedagogue Carl Eulers (1828-1901) the term "therapeutic gymnastics" includes the synonyms "medical gymnastics", "physiotherapy" and "mechanotherapy". Euler distinguishes between 'Active or German Gymnastics', 'Passive Gymnastics or Massage' and the 'Swedish Gymnastics' by Per Henrik Ling (1776-1839), which he regarded as the creator of modern gymnastics. In addition, Euler also mentioned lung physiotherapy, the treatment of stuttering, and the 'Terrainkur' introduced by German internist Max Joseph Oertel (1835-1897) in 1875 for the prophylaxis and therapy of heart disease.
Italian physiologist Angelo Mosso (1846-1910) during an experiment with a spirometer.
The British Medical Association (BMA) demanded training for massage practitioners because it found that massage in prostitution was often associated with unskilled workers who worked with forged degrees. In response to what is known as the 'Massage Scandals' of 1894, the four nurses Lucy Marianne Robinson, Rosalind Paget, Elizabeth Anne Manley and Margaret Dora Palmer founded the 'Society of Trained Nurses', which later became known as 'Chartered Society of Physiotherapy'. The four wanted to protect their profession after stories in the press in which the public was warned about unscrupulous people who offered massage as euphemism for other services.
In 1894 the principle of the closed-circuit system of Henri Regnault (1810-1878) and Jules Reiset (1818-1896) was applied to humans by German physiologist and chemist Ernst Felix Immanuel Hoppe-Seyler (1825-1895) (photo). The CO2 was absorbed from the air via a potassium carbonate solution and the O2 was absorbed into the system via a gas meter. The CO2 was subsequently removed from the potassium carbonate solution with sulfuric acid and absorbed in a device which was then weighed. The oxygen values were obtained by measuring a gazometer from an air analysis in the respiration room. The Hoppe-Seyler respiration room had a capacity of 4.8m³.
In 1894, Swedish physician and physiotherapist Truls Johan Hartelius (1818-1896) published his book 'Treatment of diseases with Swedish gymnastics'. In 1867 he had already published 'Textbook on the special anatomy of the human body' and in 1870 'Textbook of Physiotherapy'.
French physician Guillaume Duchenne de Boulogne (1806-1875), generally regarded as the father of electrotherapy, experimented for the first time with galvanic flow on muscles and nerves in the Paris Hôpital de la Salpétriere. The method allowed to specify the function of for every muscle function of the human body and to diagnose certain diseases by locating the cause.
German physiologist Adolf Löwy (1862-1937) did extensive physiological research at a high altitude. For this he worked together with his teacher Nathan Zuntz (1847-1920), Italian Angelo Moses (1846-1910) and Austrian Arnold Dürig (1872-1961). With Austrian physiologist Hermann von Schrötter (1870-1928) he did pioneering work in the field of pulmonary haemodynamics. Some of his important works:
By using an improved electrometer and thanks to a correction formula, Dutch physician Willem Einthoven (1860-1927), irrespective of his American colleague George J. Burch (1867-1935), distinguished five deviations that he named P, Q, R, S and T.
Why PQRST and not ABCDE?
The four derivations for the correction formula were called ABCD and the five derived deviations PQRST. The choice of P is a mathematical convention (as used fifty years earlier by Du Bois-Reymond in the 'disturbance curve' of his galvanometer) by using letters from the second half of the alphabet. N has a different meaning in mathematics and O was used for the origin of Cartesian coordinates. Actually, Einthoven used O ..... X to indicate the timeline on his diagrams. P is simply the next letter. A lot of work was done to reveal the true waveform of the ECG by excluding the muted effect of the moving parts in the amplifiers and the use of correction formulas. If you look at the diagram in the publication by Einthoven from 1895 you will see how well the recordings of the string galvanometer resemble those of the current electrocardiograms. The image of the PQRST diagram was shown to be adopted by researchers as a correct representation of the underlying form. It was therefore no more than normal that the same name was used when using the more advanced devices.
French surgeon Just Lucas-Championnière (1843-1913) of l'Hôpital Beaujon became the first chairman of the Association for Physiotherapy in 1900 and in 1889 he published his book 'Traitement des fractures par le massage et la mobilization', of which a more complete version appeared in 1895. This didactic work with specific plans, clear arguments and illustrated with photographs is the first practical book about the massage to be applied in the treatment of fractures.
Together with his colleague Sondén, Finnish physiologist Robert Tigerstedt (1853-1923) designed a large chamber for measuring gas metabolism in Stockholm.
In the space of 100m³ several people could take a seat, but only the carbon dioxide production was determined.
To gather more information about the metabolism, German physiologist Nathan Zuntz (1847-1920) developed a pneumatic steel case with treadmill to simulate atmospheric conditions of heights above 11,000 meters.
In 1895 the young French physician Paul Archambaud (1864-1952) opened 'L'Ecole Française d'Orthopédie et de Massage', the first school for massage training. The education was divided into two parts. The manual orthopedics reserved for doctors and medical students consisted of massage therapy and resetting the limb. On the other hand, there was the massage for lay masseurs so that they could gain sufficient knowledge. At the end of the course and after a successful exam, the student received a certificate stating that he was able to heal sick people with massage and that he undertook the massage only after a medical prescription.
A photo on page 180 of 'Transactions-American Society of Heating, Refrigerating and Air-Conditioning Engineers' shows an observation room with a body thermometer in the middle of the wall. Bottom right is a bicycle ergometer, the controlling rheostat is on the table. Left is a spirometer that collects and measures the exhaled air.
The 'Veeder Manufacturing Company' brought the first cyclocomputer to the market in 1895 with the slogan 'It's Nice to Know How Far You Go'.
German physicist Wilhelm Conrad Röntgen (1845-1923) discovered the X-rays referred to him, for which he received the Nobel Prize in Physics in 1901. Thanks to this invention, the possibility of diagnosing and managing orthopedic disorders improved.
Austrian Heinrich Ewald Hering (1866-1948), who was Professor of Medicine at the University of Prague, experimented with rabbits and showed that increased heart rate was the result of increased neural activity of the accelerator nerve coupled with a decrease of the vagal nerve.
Orthopedic surgeon Georg Ritschl (1861-1945) started an academic training in massage and mental gymnastics for medical students at the Universität Freiburg.
German surgeon Johann Hermann Lubinus (1865-1937) founded in 1895 in Kiel the 'Anstalt für Heilgymnastik, Orthopädie mit Massage samt medico-mechanicem Zander-Institut'. After a stay at the Swedish National Institute in November 1900, he started in his clinic also the first state school for a two-year training course for curative gymnastics. Lubinus published in 1913 in the 'Münchener Medizinischen Wochenschrift' about the purpose of his education:
"In the beginning I was satisfied with a small number of students to get first an overview of how these curative gymnasts fit our German situation, because the fact was possible that they could possibly conflict with the medical interests. to prevent such a danger, on the one hand by the fact that I clearly indicated in the class the boundaries of their work area, on the other hand also by the fact that in the certificate a passage was included that one should only perform curative gymnastics and massage treatments after a medical prescription."