Capsules

>Because doctors have no totally accurate way of judging the strength of bone while it knits, they often immobilize broken limbs longer than necessary. Overtime in traction could soon be eliminated, however. John Jurist, a biophysicist, and Dr. Edmund Markey, an orthopedic surgeon at the University of Wisconsin Medical School, are experimenting with a technique that could enable physicians to determine with precision whether a bone is strong enough to bear weight. So far, their research has focused exclusively on a long leg bone, the tibia, to which a vibrating machine is attached. After the bone is vibrated at various frequencies, responses are measured and the resonance of the tibia indicates its rigidity. The test is then repeated on the patient's unaffected leg and the two findings compared. In studies of 26 fracture patients, Jurist and Markey found an "extremely good" correlation between resonance frequency measurement and the time elapsed since the fracture.

>When a patient's symptoms point to a definite, diagnosable disease, the treatment--surgery, drugs or other therapy--is often obvious. But what should a doctor do when the symptoms add up to no known ailment? Dr. Joseph Sapira, a Birmingham, Ala., internist, believes the physician definitely should not dismiss the complaint as imaginary. Instead, he should try "reassurance therapy," and in the Annals of Internal Medicine Sapira tells how to administer it. The first step, he says, is to elicit a detailed description of the symptoms; the next is to ascertain how they affect or concern the patient.

Examining the patient is crucial because the "laying on of hands will dramatically increase the effectiveness" of what is to follow. The doctor can then make his "diagnosis," ruling out those conditions that the patient does not have, particularly the one that worries him most. Finally, the physician can explain the symptoms to the patient and assure him that they are harmless. Under no circumstances, however, should he try to deny the existence of pain or discomfort. Most patients dote on their symptoms, and will shop for a physician who is just as interested.

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