The Vogue of Rest

In the days when doctors had little or nothing else to offer their patients, it was natural enough for them to prescribe bed rest. Today, says California's Dr. Sedgwick Mead, prolonged rest is in a class with bleeding and purging. It has long since been proved that there is no scientific justification for the "vogue of rest." but too many of his colleagues, says Dr. Mead, go on prescribing it, not only in cases where it does no good, but often when it does actual harm.

Proposed a century ago as a remedy for mental disturbances, writes Dr. Mead in the A.M.A. Journal, the rest cure in such cases was "surely the least effective of all the ineffective treatments before or since." When Dr. Mead was a medical student in 1938, the average length of confinement after delivery was 18 days. "As a result, it occasionally occurred that an otherwise healthy young woman dropped dead of a pulmonary embolism as she was getting into a taxi with her baby to leave the lying-in hospital." Confinement after delivery is now little more than three days, and fatal blood clotting in such cases is virtually unknown.

It took doctors almost half a century to accept scientific evidence that surgical patients do better if they are out of bed and walking as soon as possible after an operation. And despite the amazing recovery of former President Eisenhower after artery shutdowns in both heart and brain, Dr. Mead complains that doctors are still turning heart-attack victims into nervous wrecks and frozen-shoulder cripples by enforcing too much rest.

As director of the Kaiser Foundation Rehabilitation Center in Vallejo, Dr. Mead is a specialist in physical medicine and deals mainly with patients whose ability to exercise has been catastrophically cut--elderly stroke victims and teen-agers with broken necks from diving accidents, or children paralyzed by polio. The polio patients used to be immobilized in plaster casts for months, until all hope of restoring strength to atrophied muscles had vanished. No more. Even the weakest muscle must be exercised, Dr. Mead insists.

Outside his own specialty, Dr. Mead criticizes doctors for continuing to impose "prolonged inertia" on patients with an arterial shutdown in a leg, and on victims of rheumatic fever. Strenuous athletics, he notes, are even recommended for patients with active tuberculosis, provided they are also getting drug treatment. Excessive rest, he concludes, is the same fraudulent fad it always was.

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