AN AMBULATORY CHAIR

FRANK G. NIFONG, M.D., F.A.C.S.

COLUMBIA, MISSOURI

It is our duty as physicians and surgeons more fully to recognize our obligations to our convalescent patients recovering from both injuries and illness, and to see that they reach complete mental and physical restoration. This accords with our newer ideas of our duties as a State to those who have served us. We should each realize more fully this obligation to our individual patients, and stay with them during what is often a most difficult and trying experience, and help them to "carry on" to complete recovery.

Every device, suggestive, mechanical, or what not, that may be helpful, should not be overlooked. Mental suggestion and all manner of encouragement are necessary to promote the more rapid restoration of the fever patient during his convalescence; and this should not be left to the unskilled. Those fractures and injuries of the lower extremeties, which have necessarily been treated in bed for a long time, leave the patient ofttimes in a most deplorable state. It requires all the skill and patience of physician and attendants if successful recovery is attained. After such injuries and protracted illnesses it is not only the emaciation and flabby muscles with which we must deal, but likewise a mental state which is equally as flaccid.

It is the proper estimate of the real condition of such a patient which we wish to emphasize and to protest the perfunctory prescription of a pair of

crutches and such unskilled help in getting up and out as may, by chance, be available.

This weakened mental and physical state so analogous to that of a little child beginning to walk has suggested the helpful appliance which I wish to present. It is simply a modification of the well-known baby-walker adapted to the needs of such patients.

Figure 1 fairly represents the device. It should be made of light, strong material, preferably of hickory or ash, and of dimensions which allow passage through ordinary doors. The end opposite the seat should be open, as shown, so entrance from the bed may be easy, as you will note in Fig. 2. The manner of walking and supporting the weight of the body partly by the arms is also shown in Fig. 3. At any moment, when the patient feels faint and tired, he may sit down, as you will note in Figs. 4 and 5. With four points of support in addition to his own legs, the patient is very soon able to walk, and even ascend stairways with perfect safety.

Some very good reasons for the use of this chair and its adoption as a part of the armamentarium of well-regulated hospitals might be given.

In the first place, it inspires confidence in the convalescent and cripple, and quickly promotes selfreliance, which is a very necessary factor in promoting recovery. He soon goes along without attendants, and much more quickly than if he depended on them. He realizes that he is supported by a broad base and has no fear that he may fall. He sits down as soon as he is tired. He enters from his bed with ease, and may be encouraged to take care of himself from the beginning of his efforts, which is so important psychologically.

In the second place, the patient needs much less assistance from attendants, and very soon may do without them. This is not an unimportant considera

Fig. 1. This illustrates the ambulatory chair. be made of light strong wood. It must It must not be too wide, but must freely pass through the average two-foot eight-inch door. The length at the bottom is 47 inches; width at bottom, 29 inches; length at top, 49 inches; width at top, 24 inches; height of seat, 16 inches.