Selected monographs.

  • New Sydenham Society.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    of unsuitable bandaging apparatus, that would sometimes not happen had the repair been left to nature. And Herrgott says also (p. 352): We much regret that we cannot completely agree with Neugebauer's final conclusion, which is thus stated : ■ Spondylolisthesis is a surgical deformity, occasionally due to some anomaly in the ossification of a vertebral arch, but more frequently caused by an injury.' Neugebauer's view, he states further on, appears to us less satisfactory than our own, for he docs not give to inflam- matory action that important part in the matter which it appears to us to play. If the injury was the effective cause, the deformity would be an immediate result, and this is not the case; more or less time, and generally a very long time, consisting of months, or even years, elapses before the deformity, which does not arise until the consistence of the vertebra is so modified by inflam- mation that it is too feeble to support the rest of the spinal column, is produced. In answer to this I would in the first place point out that Herrgott has now abandoned the causativo action of Potts' disease he formerly insisted on, and attributes the loss of resistance in the interarticular portion of the vertebral arch to a chronic inflammatory condition. But to what is this chronic inflammatory state and softening itself due ? It cannot be a primary condition, but is itself due to some fracture or injury. While I look upon this injury, without which neither Herrgott's chronic inflammatory softening nor olisthesis could have occurred, as the origin of this olisthesis, Herrgott, on the other hand, refers the genesis of the olisthesis to a condition of the vertebral arch which I insist was secondary, and says, nevertheless, on pp. 350, 351, This chronic inflammatory state of irritation is according to the anamuesis generally due to an injury. He enumerates all the fractures and injuries mentioned in the anamuesis of the several cases which I have set down, and then says, The maximum effect of all of these injuries must result in the lumbo-sacral region. Have we not here the most frequent cause of chronic inflammations of the bone ? Once the inflammatory condition resulting from injury is admitted, tho process becomes clear. The deformation of the bone, such as we see, can only result if the bono has lost its resistance under some chronic influence, for only then could it be elongated,