Zander, has in the last thirty years developed a system of mechanical movements, both active and passive, given by means of apparatus. In these the resistance and amount of motion can be graduated to the patient's needs, and the personal element of the operator is eliminated. Each system fulfills certain indications, and neither can wholly supplant the other. If the Swedish school had given us nothing more than passive movements in therapeutics, our debt would have been great. The extraordinary prominence in recent years of massage as a remedial agent, in so far as it is justified by results, rests largely on the employment with it of passive movements. These enable the patient to obtain many of the benefits of exercise without effort and without undue fatigue, and can be employed in thousands of cases when active exercises are contraindicated or impracticable. Through passive exercises may be obtained the local effects of exercise on the circulation, easing of cardiac action or its gentle stimulation, mental discipline, or mental sedation, as in the soothing effects of rocking or swaying movements on infants; in a word, the more harmonious distribution of nervous and vascular activity.
It is well to remember Ling's adage that every movement properly performed is a respiratory exercise, and it is probable that respiratory development may be best attained through climbing, running, and similar exercises by those who are strong enough and energetic enough to take them. Those who most need them, however, are neither strong nor energetic, and it is often impossible to get patients to practice the purely respiratory exercises with sufficient care and persistence. In such cases, where more thorough pulmonary ventilation and respiratory power are required, passive respiratory movements, manually or mechanically given, often serve a useful purpose.
There is no more promising field for the therapeutic application of exercise than in the treatment of the insane and mentally unbalanced and defective. The elder Seguin has shown that the idiotic brain could be most effectively reached and developed through neuromuscular training, especially of the hand, and the value of manual employments, industrial training, and social life has been to some extent recognized in provision for the epileptic, idiotic, insane, and criminal. The striking and oft-quoted results obtained by Dr. Wey in the physical training of vicious and stupid criminals at the Elmira Reformatory by means of improved diet and systematic bathing, massage, drill, and gymnastics, mark an era in the treatment of the defective classes. A large proportion of previously incorrigibly dull and vicious individuals submitted to a few months of this treatment improved remarkably in physical and mental condition. It is safe to say that better provision will be made in future in our public institu-
