The elements of Kellgren's manual treatment
Cyriax, Edgar Ferdinand
Although massage and medical gymnastics seem to have been in use as far back as authentic records of history can lead us, the first to attempt a movement cure on a scientific basis was the Swede, P. H. Ling.Ling's system soon awoke public interest, though his attempts to get the Swedish Government to assist him in founding an institution were at first futile. However, in 1813 the Royal Central Gymnastic Institute, subsidized by State, was opened for him in Stockholm and he was appointed at the head of it.The medical part of his system the profession . did not take to readily at first and did all it could to prevent its gaining ground. Ling and his pupils, however, persisted in their efforts to get a recognition from them, by showing them practically what they could do - and finally attained success, although this took many years to effect.Ling died in 1839 and according to his own words, left behind him only two men who really under- stood his system and who were capable of furthering its progress and aiding in its development. These were Gabriel Branting and Augustus Georgia.Henrik Kellgren, born in 1837, entered the Central Gymnastic Institute at Stockholm, 1863, and worked there under Professors Branting, Hartelius and Hjalrnar Ling until 1865. After leaving, he commenced to practise as a Gymnastic Director. He soon found many shortcomings in Ling's system, which he corrected; and he likewise improved many of the manipulations and added some practically new ones, without however attempting to make these known by writing about them. Not only this, but he brought his treatment into quite new spheres with great success; for he was able to apply it, for example, in the treatment of acute conditions - not merely in such cases as acute joint inflammations, but in those like scarlet fever, pneumonia, typhoid, etc. Among his additions and inventions we must first mention his direct nerve treatment. Although a kind of nerve pressing had been used before to a small extent, he replaced this by nerve frictions and nerve vibrations - infinitely superior methods. These have been able to accomplish so much that could not be done before, that all the medical profession in course of time have had their attention drawn to them; and the name of "Kellgren's nerve frictions and vibrations" is one which is well known to them all.In the course of 36 years continued practice, Kellgren has been able to introduce improvements into all the exercises he had taken from Ling's original system; he has modified some, discarded others, and ones. improvements have drawn a well- marked line between Ling's methods and his, and we can thus regard his system as standing alone, as one complete in itself, and as such it stands ripe and mature for the medical profession generally to adopt. Until now, however, very few medical men have taken an interest in it and the literature on the subject is of the most scanty. The only writings which treat of Kellgren's method, exclusive of a few brief articles in various periodicals, are those of Dr Arvid Kellgren, Gymnastic Director, Stockholm, 1879, M.B., C.M., Edin., 1886 who for many years studied under his brother, Henrik Kellgren, and whose "Technic of Manual Treatment" was accepted in 1889 by the University of Edinburgh as a thesis for his degree of M.D. with recommendation. No one, however, has as yet endeavoured to give anything like a systematic description.Neither have the practical results of Kellgren's treatment awakened much interest amongst his own gymnastic colleagues, although some of them have come to him to study this method. Professor Hartelius was one of them; after visiting Mr Kellgren's institute, he wrote a very favourable opinion in "Tidskrift I Gymnastik" (the bi- annual journal of the Central Gymnastic Institute) for 1886, part VII, p.444. Dr Levin, now head of the department for female students in the Institute, did the same in the second number for 1892, page 687, and not only that, but endeavoured to learn some of the manipulations of Kellgren's method that were new to him and introduced them with success into his clinique on his re- turn to Stockholm.In my opinion, the time has come when Kellgren's treatment should be recognised and receive the place it deserves in the world of modern therapeutics. This little work is only meant to try and give an impulse in this direction and to interest the medical profession in its workings. I sincerely trust that it may fulfil its aim and that this treatment will receive the acknowledgement it so richly deserves.