To study, to write, to publish ?

Dr Med Sci Hanna Nohynek writes in Suomen Lääkärilehti - Finnish Medical Journal - for two weeks ago how her study in certain vaccines has not been accepted by a medical journal in U.S. and by Lancet in Britain.

I presume that article is then not published - at the moment.

There's a question : Why don't she and her colleaques publish that article in a scientific blog, at least ?

Why should one accept conservative and slow system of scientific publishing if you have something important to say ?

At least you should tell the relevant people what you are doing and what your study shows.

They certainly estimate the value of the findings.

My article about "medial prehension" was not either published in scientific journals to which I sent it for some years ago.


It's here now :  You're wellcome !

Singing is a Medicine - a Good One !

Dear Guests :  Singing is one of the really good medicines. Two links which pay attention to the value of singing :  The link of singer and regisseur Wiebke Hoogklimmer is worth to see : www.volksliedsammlung.com  It is about German Folk Songs as therapy for people suffering from dementia (Alzheimer's disease).


It is Kalevala day today in Finland.  Here is a link to my own singing too : "Laulu veret värähyttää" - meaning about "Song makes my blood to quiver".  It is a song to a Kalevala poem measure - my words and melody.  http://www.youtube.com/watch?v=afCfMEMN4t4 


And now we'll sing .. !


By the way : 



Music can be medicine, and music - and other arts - can be made by "medicine men". 
Look here : 


http://www.doctorshobbies.com/newsletter/2012/newsletter2012-01.html

What is the task of science ? Mikä on tieteen tehtävä ?



                                                                                         

                                                                                                                   Copyright A. Hernesniemi



Blacksmith / Seppä / Smed Karl-Johan Nyström, Pensala

Blacksmith / Seppä / Smed Karl-Johan Nyström, Pensala, Finland

Topmost photo : Blacksmith Karl-Johan Nyström on a corn field road near his home and his smithery on a sunny day in June 1982. In the scenery behind him you can see grey hay barns typical for Ostrobothnia. Near him on the ground there's an instrument for cutting of iron wires.  
Photo above : The smith demonstrates his work with a coarse forging equipment that he has built in his smithery in Pensala in Ostrobothnia.  With his right foot he adjusts the busy hammering of the construction on and off. One of his favorite products was to forge u-shaped "märlor" - fasteners to e.g.  barn doors.  (Photos : A. Hernesniemi).

Ylin kuva : Seppä Karl-Johan Nyström peltotiellä talonsa lähellä aurinkoisena päivänä kesäkuussa 1982 Pensalassa. Takana näkyy Pohjanmaalle tyypillisiä harmaita heinälatoja. Hänen lähellään maassa makaa rautalankojen katkomislaite.
Alakuvassa hän takoo rautaesinettä rakentamallaan koneellisella taontalaitteella. Oikealla jalallaan hän laskee ahkerasti työskentelevää iskuvasaraa alas kohti rautaa tai nostaa sitä. Eräs hänen päätuotteitaan olivat  u-muotoiset "määlyt" - "märlor". Niitä käytetään esimerkiksi hakaan ladonoveen tai karja-aitauksen sulkemiseksi. (Kuvat: A. Hernesniemi).

The scientific approach in ethno-medicine in Ostrobothnia by Dr Antti Hernesniemi

There are many important persons which I have met, interviewed, photographed and co-worked with during my study in ethno-medicine in Ostrobothnia.   Bonesetters, cuppers, herbalists; earth radiation revealers, healers with healing hands. And others. Many of them showed interesting, special skills which the Western medicine doesn’t know.

My both parents come from Kannus. I  was born there in 1950. Therefrom our family moved, through Köyhäjoki in Kaustinen and Aitoo in Luopioinen, to Ruovesi, in Northern Häme, in 1956. I went to school there and became a student. There I learned the basic skills with piano and played in a teen agers’ guitar band and a jazz band.

Some of these Ostrobothnian persons, since 1981 ,were especially impressive to me, a young but  curious  scholar of folk traditions. Mrs. Ina Känsälä (born Nygren, from Nedervetil), an indigenous bonesetter who lived in Kaustinen,  became the central figure of my medical thesis (Hernesniemi 1999), in the treatment methods of   bonesetters (“jäsenkorjaaja”, “kotknackare”). I  was deeply impressed when I met her for the first time. There was my central folk tradition person really worth to meet !  Mrs. Känsälä  was a specialist in her  family healing traditions. She was a real folk artist with the beautiful and effective movements of her hands.  

There was Mr Eero Hautala, a folk musician, an accordion player, whose music, arrangements and compositions I recorded on tape – as I did with all those tens of people with whom I discussed.  Eero Hautala introduced me to his friend  Mr Aleksi Kultalahti from Evijärvi, a farmer and specialist in local histories. He was a man who had thousands of tales of the past and today to tell. There was a blacksmith who would have liked to be a poet, Mr Karl-Johan Nyström  in Pensala (see the photos and story above). He made poems about local people’s lives in the village and about himself.  I have composed two of his poems.

In those years I met many healers with healing hands. One of them was  Mr Vilho Viljanmaa living in Sykäräinen. They had a power in which they and their patients trusted.  But this was not usually the case with authorities of the Western medicine which is based mostly on physics and chemistry. It is not paying much attention to peoples’ own experiences. Which you cannot maybe measure with a conventional scientific device. 

All these inspiring people I met during my study in ethno-medicine in Ostrobothnia.  I would not have met them without this work of a young physician in the region. They were not important for the medical faculties in Finland in 1960’s and 1970’s. They are not important even to day.

Should scholars be responsible ... of something ? Onko tutkijoilla vastuuta ... jostakin ?




Copyright A. Hernesniemi

 

EthnoDrawings by Dr A Hernesniemi : Bonesetter - "jäsenkorjaaja" - from Ostrobothnia, Finland





Fig. 1. Bonesetter Mr Arvi. In this "positiographical drawing" Ostrobothnian bonesetter Mr Arvi Louko from Ylistaro presents his idea of functioning of a joint with his hands. The drawing is based on a narrow gauge S-8 film recorded by Mr Anders Nordström with the author at the second visit to the bonesetter in 1981. This drawing is made with the "medial prehension" drawing method during "positiographical cinemanalysis"  (Hernesniemi 1999).




Piirros 1. Jäsenkorjaaja Arvi. Tässä positiografia-piirroksessa pohjalainen jäsenkorjaaja Arvi Louko Ylistarosta havainnoi käsillään kertomustaan nivelen liikkeestä.  Piirros perustuu  insinööri Anders Nordströmin ja tekijän kuvaamaan kaitafilmiin. Tapasimme jäsenkorjaajan hänen kotonaan Ylistarossa vuonna 1981.  Olen tehnyt tämän piirroksen kuvaamallani "mediaali-ote"-piirtämismenetelmällä positiografisen kinemanalyysin avulla (Hernesniemi 1999).  

Bored with science ? Kyllästynyt tieteeseen ?

Please look at the blog with my paintings and song texts  :

http://www.nousevatmetst.blogspot.com

My music can be ordered through :



http://www.fuga.fi/detail.php?id=S%C3%84VE1

and:

http://www.arkivmusic.com/classical/Name/Antti-Samuli-Hernesniemi/Composer/244700-1

Sivujeni Lukijoille - Dear Readers

Hyvät Sivujeni Lukijat :  Mukava että teitä on käynyt aika paljon katsastamassa näitä sivujani.
Tarkoitukseni on hiljakseen tuoda tänne erilaisia asioita tieteen parista.
Nimensä mukaisesti tälle blogille tulee lähinnä etno-tieteiden asioita. 

Olen kiinnostunut teidän palautteestanne. Voit lähettää ne suoraan sivulle tai minulle alla olevaan osoitteeseen.

Hyvää viikkoa,
Antti Hernesniemi
Lääket. tri
Musiikkitieteen maisteri-linjan opiskelija
Turku



Dear Readers :  It's nice that you have been visiting my pages. I'm going to bring new things here, little by little. I'm interested about your comments.  Please send them to this blog or directly to me.
Best regards,
Antti Hernesniemi
Dr Med Sci
Master-line student in musicology
Turku
Finland


antti.hernesniemi@fimnet.f  

Tiivistelmä "mediaali-ote"-esityksestä. Helsinki 2002.

Hernesniemi, A : Uusi menetelmä kirjoittamiseen ja piirtämiseen:  "mediaali-ote" 

 ("Medial Prehension", a New Method of Holding Pen During Writing and Drawing).   Poster. Lääkäripäivät; Messukeskus, Helsinki, 6.-10.1. 2002.

Lapsille on kauan opetettu  perinteinen kirjoittamis- ja piirtämisote, "radiaali-ote",  jossa  kynä laitetaan peukalon ja etusormen väliin. Tässä työssä esittelen uuden  kynääntarttumis- ja kirjoitusmenetelmän, “mediaali-otteen”.  Sitä voi käyttää myös sondimaisilla  instrumenteilla työskentelyyn. Kynän (instrumentin) varsi laitetaan etu- ja keskisormen (tai keski- ja nimettömän sormen) väliseen hankaan ja kynän (instrumentin) kärkeä pidetään peukalon, etu- ja keskisormen välissä - samojen sormien välissä kuin perinteisessä radiaali-otteessa. 

Mediaali-otteen edut radiaali-otteeseen verrattuna ovat seuraavat: Kun kirjoittaja, piirtäjä tai pitkänomaisella instrumentilla operoiva henkilö käyttää mediaali-otetta, hänellä on  mahdollisuus ottaa tukeva ote kynän (instrumentin)  varresta ja pitää kättä maksimaalisessa pronaatio-asennossa, kämmen kohti työalustaa. Hän voi tukea kättä sekä thenar- että hypothenar-alueilla. Hän pystyy nojaamaan kyynärvarttaan pitkien koukistajalihasten laakealla massalla työalustaan. 

Sitävastoin kun kirjoittaja tai piirtäjä käyttää radiaali-otetta kynästä (tai instrumentista), rannetta täytyy nojata työalustaan siten että kämmenen ulnaarinen, pikkusormenpuoleinen hypothenar-alue on vasten alustaa. Tämän seurauksena on henkilön kirjoittavan käden - kyynärvarren, ranteen, kämmenen ja sormien - ja siten kynän  asento vähemmän vakaa kuin mediaali-otetta käyttäessä.

Mediaali-otetta käyttäessä on helppo pitää tukevasti kynän (instrumentin) varresta kiinni: se tapahtuu käyttämällä interosseus II -lihaksia, sekä anteriorisia että posteriorisia.  Mediaali-ote ei vaadi käyttäjältä niin paljon puristusenergiaa kuin radiaali-ote, koska etu- ja keskisormen (tai keski- ja nimettömän sormen) tyvijäsenten välinen tila on kapea. Tätä käden anatomista kohtaa voi hyvin hyödyntää ohuiden, pitkien esineiden kiinnipitämisessa.

Mediaali-otteen käyttäjä voi tarkasti kontrolloida kynän (instrumentin) kärjen liikkeen, vaikka pitäisi etu- ja keskisormilla korkealta kiinni kynän (instrumentin) varresta. Niinpä mediaali-otetta voi käyttää töissä, joissa kynän (instrumentin) kärjen tarkka asemointi on tärkeää, esim.  pitkillä ja kapeilla  instrumenteilla työskentelyyn. Mediaali-otteesta voivat  hyötyä käsivammaiset henkilöt, joilla peukalon ja/tai etusormen käyttökyky on puutteellinen.

Update Dec. 2013 : More about "medial prehension" - "Mediaali-ote" ja kynä

My pioneer approach in the article/poster you have read here, was not any experimental one. To shed light on this area, I wanted to interview some voluntary persons which contacted me and which had been using "medial prehension" - as I call it. This area is TOTALLY uninvestigated. Therefore I wanted to get some " first glance view", some clarity on this interesting situation in the pedagogical field. 

Finnish school teachers have not been interested about the ways we learn to use our most important instrument, pen or pencil. Not even teachers of drawing and painting at academies.

This item - how we use the pen - is of uttermost importance.  With this grasp, this grip we decide how our brain, our thinking, our creativity develops.

Best regards,

Dr. Antti S Hernesniemi

Turku

Finland

The author has used "medial prehension" drawing and writing method since 1995 when he found it - not as the first inventor, as he  soon could notice. He has earlier presented the grip at the annual meeting of Finnish Medical  Association in Helsinki in 2002.

“Medial prehension” - as the author calls it - is a grip in which, instead of holding a pen between one's thumb and index fingers, the writer holds it between his or her index and middle fingers. This is an ergonomic grip :  one doesn’t get weary as easily as before. You'll get better drawing and writing results  than with the conventional grip.

After the author's poster presentation in January 2002 and a redactor's article in Helsingin Sanomat, a Finnish pianist contacted me and showed me a book with a picture of composer Maurice Ravel. He held the pen in "medial prehension".  Reading  recently a book about Hungarian folk music I saw a photo of  composer Zoltán Kodály: he was holding a pen in the same way.  Some Helsingin Sanomat readers - altogether 60 people contacted me - further told me that other famous "medial prehension" writers have been author Anne Frank; Marshal of Finland CGE Mannerheim and bishop Väinö Malmivaara.

Antti Hernesniemi



Esittelin "mediaali-otteen" kirjoittaessa ja piirtäessä ensimmäistä kertaa tammikuussa 2002 Lääketiede-tapahtuman poster-näyttelyssä Helsingissä. Asiasta kerrottiin silloin myös Helsingin Sanomissa. Sain kuutisenkymmentä yhteydenottoa Sanomien artikkelin lukeneilta henkilöiltä. Tulin tietämään, että mm. marsalkka Mannerheim oli pitänyt kynää mediaali-otteella kirjoittaessaan. Tämä on nähtävissä erään hänestä luodun biografian kuvassa, jossa hän kirjoittaa pöydän ääressä. Piispa Väinö Malmivaara oli myös kirjoittanut ko. otteella.

Monet HS:n artikkelin lukeneet kertoivat, että he itse tai joku heidän tuntemansa henkilö on käyttänyt mediaali-otetta. Eräältä pianistilta kuulin, että ko. otetta oli käyttänyt myös säveltäjä Maurice Ravel. Erään biografian kannen kuvassa hän pöydän ääressä kirjoittamassa. Eräs yhteyttä ottanut lukija kertoi myös nuoren kirjailija Anne Frankin olleen mediaali-otteen käyttäjä. Vuosi sitten huomasin eräästä Unkarin kansanmusiikkia käsittelevästä teoksesta, että säveltäjä Zoltán Kodály myös piti kynää "mediaali-otteella".

Minulle tarjottiin mahdollisuus käydä tuolloin myös tutustumassa eräässä päiväkodissa Espoossa piirrustuksen opetukseen esikouluikäisille lapsille ja heidän käyttämiinsä kynäotteisiin. Niin teinkin - käynti oli kiinnostava. 

"Mediaali-ote" mahdollistaa kirjoittavan käden rentouden ja hyvän tasapainon ja tuottaa siten hyvän kynänjäljen. Olen itse tyytyväisenä käyttänyt yli viisitoista vuotta tätä mediaali-otetta.  Tässä esittelemäni ote ansaitsisi kirjoittamisen ja piirtämisen tekniikkaa opettavien ja ergonomisia asioita pohdiskelevien henkilöiden kiinnostuksen. 


Antti Hernesniemi

Lähdeluettelo tarvittaessa.  

Homepage - Kotisivu :

http://personal.fimnet.fi/laakari/antti.hernesniemi/Antti_Hernesniemi/home.html

Dear Readers

Dear Readers :

I am a Doctor of Medical Science specialized in the Finnish ethnomedicine. During my studies in the Ostrobothnian bonesetters in Finland in 1980's and 1990's, I was  surprised of the practicality and beauty of the working of some of them. Therefore I wanted to find a way to present their work and their hand movements in a more distinct way than what I could find presented in the relevant literature. So I developed a pictorial method to study narrow gauge 8 mm movie films. At that time I had recorded with the help of these practical - but today almost forgotten - colourful and impressive films these common folk therapists' collaborations with their patiens. 

The details of the study are presented for the first time in my medical thesis "Presentation of  bonesetter-patient collaboration through positiographical cinemanalysis" (Hernesniemi 1999). Some of the essential details of the method are presented in my blog. "Medial prehension" method - as I call it and present it - is published internationally and in internet here for the first time in English.  These drawing and writing method details are not mentioned in my thesis. 

It is my plan to publish some of my scientific ideas - mostly in ethnomedicine, but from other areas too -  now and then in this blog.

I hope the things I present here are interesting for you. I hope I'll get some comments and questions from you too ! 

With best regards

Antti Samuli Hernesniemi

Dr Med Sci

Master-line student in musicology

Turku

Finland

I am studying musicology at the Åbo Akademi University in Turku. Those interested in my music please visit :

http://www.arkivmusic.com/classical/Namedrill?album_group=5&name_id=244700&name_role=1

"Medial prehension" in "Positiographical Cinemanalysis" by A Hernesniemi

Hernesniemi, A. Presentation of Bonesetter-Patient Collaboration through  Positiographical Cinemanalysis.  Acta Universitatis Ouluensis. Series D Medica 538. Oulu University Press. 1999.

Co-operation work of bonesetters, folk therapists of pain and other muscular and joint ailments, with their patients, has usually been presented by means of the photographs and drawings, and the documentary film, and with the terminology specific to manual medicine. The objective of this study was to present an 8 mm documentary film, recorded at a bonesetter-patient collaboration, through a modified application of cinemanalysis, presented by Arnold Gesell in 1935, by developing concepts and a method to study movie film with free-hand drawing.

Collaboration was recorded on an 8 mm movie film in Finland in 1981. The author examined the 7173 frames of the five-minute film through an editor viewer and drew 80 sketches on an opaque paper of the bonesetter/patient in such positions of the collaboration, which seemed relevant. Of these, 47 sketches were prepared to pictures and were provided with a textual anatomical description.

In most of the pictures, the exact position of the hands of the bonesetter on the patient’s body could be observed. The patient sat on a chair in front of the standing or sitting bonesetter. The patient held his arm abducted for a period and made a few forward flexing-extending movements of his body. The bonesetter worked on four topographical areas on the patient’s body in nine successive stages. Pictures were classified according to hand-contact positions: 1; bonesetter without hand contact with patient, 2; bonesetter in hand contact with unmoving patient, 3; bonesetter in hand contact with moving patient.

Position 1 pictures present how the bonesetter performed observations (inspections) of the patient. Position 2 pictures present how she performed touchings (palpations) with the fingers of one or both hands on the regions of the arm and shoulder, back, and head and neck. She used her hands in touchings (palpations) in vertical pronated, transversal or vertical supinated position. The bonesetter touched the patient with a combination of various fingers, using apical, apical-palmar or palmar parts of the fingers. She performed ”pushing”, ”gliding”, ”kneading” and ”walking” touchings (palpations). Position 3 pictures present how the bonesetter performed turning and lifting body movements on the patient’s shoulder, central compressions on the back regions, shoulder and back leverings and head and neck lateral bending movements. The bonesetter visualised her therapy with teaching hand positions. The topography and positions of the collaboration were presented in a diagram. The contact positions were explained with anatomical terms.

The method illustrated bonesetter and patient positions during manoeuvres, which had not been previously published in literature and with a greater accuracy. This method could be applied to investigate the cooperative efforts of other hand operators and patients.

Keywords: observation/inspection, touching/palpation, movement, drawing.

                                                               Copyright A. Hernesniemi

In this drawing G from my thesis - in a series of near fifty drawings - I have presented  bonesetter Ina Känsälä's (born Nygren) right hand fingers on the neck of the patient.  The original 8 mm movie film, source for my drawings, was recorded while she was giving a treatment to a patient with a neck and back problems in Ostrobothnia in 1981. 

"Medial prehension", a new pen method - Mediaali-ote, uusi kynämetodi

Look at this video too : 

http://ethnosciences.blogspot.fi/2016/01/medial-prehension-to-hold-pen-or-pencil.html

* * *

Antti Hernesniemi, Dr Med Sci 

"Medial prehension",  a new method  of holding a pen during writing and drawing (*)

Young pupils have, for innumerable generations, learned the conventional prehension of  holding a pen in writing and drawing. This grasp is referred to here as "radial prehension"  (R-prehension; presented as seen radially in a drawing, Fig. 1-1). In R-prehension, the writer/drawer holds the shaft of  the pen, supporting it on the area between the first and  second fingers  -  the first interosseus muscle area - and the head of the pen between the  palmar surfaces of the first finger (thumb), the second (index) finger and the radial side of  the third finger. In this article, a new method known as "medial prehension" (M-prehension)  is presented (seen radially in a drawing, Fig. 1-2, and seen anteriorly in a photo, Fig. 2).  The drawing (Fig. 1- 2) presents M-prehension in which the writer/drawer holds the shaft  of the pen between the proximal phalanges of the second (index) finger and third finger and  the head of the pen between the palmar surface of the first finger (thumb), the ulno-palmar side of the second (index) finger and the radial side of the third finger. 

What is necessary for a good pen prehension?

Kapandji (1970, 198 - 201) defines six kinds of hand prehension. Two of  these are important  in pen prehension: Prehension by "subterminal opposition" - as Kapandji calls it - of fingers,  and prehension between the two sides of fingers. The former is used in conventional radial prehension of a pen. The latter represents a medial prehension one of which the author  presents in this arcticle.

  Based on mechanical laws, a writer/drawer must hold a pen at at least two different points  along the pen shaft, or hold the shaft over a rather long portion of it, to be able to write or  draw with a steady grasp. In conventional R-prehension, the head of the pen is held between  the first finger (thumb), second (index) finger and third finger. The shaft of the pen is  supported against the dorso-radial second metacarpal area of the hand, the area of the first  dorsal interosseus muscle (see e.g. Moore 1992).

M-prehension method

In M-prehension method, the head of the pen or pencil, is held between the same fingers but  in a different way from the conventional R-prehension method,  and a long section of the  pencil shaft - several centimeters, depending on the size of the hand -  is held between the  opposite inner sides of the second and third fingers. If more convenient, in M-prehension the  pencil can also be held between the third and fourth fingers. In Figure 2, note the possibility  for a writer/drawer to have a steady grasp on the shaft of the pencil and the pronatio  positioning of the hand,  leaning with the area of the long flexors in the forearm and with both the thenar and hypothenar areas of the hand on the desk.

Author's experiment in using M-prehension

The author studied the work of Finnish folk therapists ("bonesetters") with their patients, recorded on a Super-8 narrow gauge film, with the help of an editor viewer (the approach is presented in the author's thesis; Hernesniemi 1999). The screen of the editor viewer, situated within the instrument,  is about 10 cm x 15 cm. Having made some preliminary sketches, the author noticed that he could not adequately draw sketches from the images visible on the screen with conventional R-prehension. He was unable to adjust the sharp, drawing end of the pencil precisely enough to draw all the necessary areas of the screen (an opaque paper had been placed over the screen). Therefore, he began to experiment with a new pencil prehension, M-prehension. After a short practice period, he could make sketches rather easily  and in a more precise way than earlier. Figure 3 (See Fig. G) presents a "bonesetter's" collaboration with her patient, a drawing made using M-prehension and  with the "positiographical cinemanalysis"- method developed by the author (Hernesniemi 1999).

Advantages of M-prehension in comparison with R-prehension

In R-prehension, the writer/drawer must use several hand muscles to hold the pen in a proper position. According to Kapandji (1970; 198 - 199), these muscles are the flexor digitorum sublimis muscle for the index finger, and the thenar muscles including the flexor pollicis brevis, first anterior interosseus, abductor pollicis brevis and adductor pollicis. Moreover, using R-prehension, the writer/drawer leans his/her wrist on the writing desk, usually having the ulnar side of his/her hypothenar against the desk. As a result of this, the position of the hand is not as stable as when using M-prehension. Using the latter,  one can support the area of the long flexors in the forearm and both thenar and hypothenar areas of the hand on the desk.

  In M-prehension, it is easy to hold the shaft of the pen steadily, which is accomplished using the second interossei muscles, both anterior and posterior (e.g. holding a cigarette, see Kapandji 1970; 200 - 201). It requires minimal energy because of the narrowness of the gap between the proximal phalanges of the second and third fingers, a gap which is well-suited to grasp a thin, long object.

  Further, while using M-prehension, one can control the position of the pen better than with R-prehension. The writer/drawer has a good control of the /drawing over long periods with a pencil using M-prehension is less energy-demanding than with R-prehension. The author has himself  noticed the ease, practicality and preciseness of M-prehension. M-prehension may also be used during various medical procedures where the operator works on the patient's deep tissues using a long instrument such as a sond.

Literature:

Hernesniemi, A (1999). Presentation of bonesetter-patient collaboration through positiographical cinemanalysis. Acta Universitatis Ouluensis. Series D. Medica 538. Oulu University Press. Oulu.

Kapandji, I J (1970): The Physiology of the Joints. Annotated diagrams of the mechanics of the human joints. Volume I. Upper Limb. Churchill Livingstone. Edinburgh London New York.

Moore K L (1992): Clinically Oriented Anatomy. Third Edition. Williams & Wilkins. Baltimore.

Fig. 1-1§

                                                                                           

                                                                                                                                                                  Fig. 1-2


Fig. 1-1.  Drawing presenting "radial prehension" (R-prehension) to hold a pen, as seen from the radial side of the right hand. The writer/drawer holds the shaft of the pen, supporting it on the area between the first and second fingers - the first interosseus muscle area - and holds the head of the pen between the palmar surfaces of the first finger (thumb), the second (index) finger and the radial side of the third finger.

Fig. 1-2. Drawing presenting "medial prehension" (M-prehension) to hold a pen, as seen from the radial side of the right hand. The writer/drawer holds the shaft of the pen between the proximal phalanges of the second (index) finger and third finger and the head of the pen between the palmar surface of the first finger (thumb), the ulno-palmar side the of the second (index) finger and the radial side of the third finger. 

 

Fig. 2. A photo presenting M-prehension during writing/drawing with a pencil. Note the possibility for a  writer/drawer to have a steady grasp on the shaft of the pencil and to hold the hand in a pronatio position, leaning with the area of long flexors in the forearm and with both the thenar and hypothenar areas of the hand on the desk (Photo: AH).

(*) Based on : Hernesniemi, A (2002).  "Medial prehension",  a new method  of holding a pen during writing and drawing. Abstrakti-kirja. Lääketiedetapahtuma 2002.  Helsinki, Finland 2002.   -  Contact :  Antti Hernesniemi,  Dr Med Sci,  MA :    antti.hernesniemi@sll.fimnet.fi