The hysterical element in orthopædic surgery / by Newton M. Shaffer.

  • Shaffer, Newton M. (Newton Melman), 1846-1928.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: The hysterical element in orthopædic surgery / by Newton M. Shaffer. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    40/84 (page 28)
    amined the patient, after the weight and pulley had been applied for two days, I found much the same condition of affairs as has been described in Case 4. When the first at- tempt to flex the thigh was made, the patient being in the supine position, an exaggerated expression of pain followed that would be difficult to describe, and the pelvis moved with the thigh as though an actual anchylosis existed at the hip joint. Next ,1 held the pelvis firmly, and strove to overcome the flexion. The pelvis tilted forward, and the tubera ischii, resting on the mattress underneath, became the fulcra by which the lumbo-dorsal spine was alternately lordosed or kyphosed. Abduction of the thigh was next tested. But the pelvis moved with the femur upon the op- posite acetabulum at the expense of the vertebral column. But I became convinced from various over-expressions of pain and exaggerated statements as to the effect of some simple tests, coupled with the history of hysterical convul- sions, that a neuromimesis of hip disease was present. While the patient was looking in another direction, I made a persistent, but not forcible flexion, and after a few seconds of determined resistance the joint suddenly yielded. So it proved regarding the other movements, until, after a time, free passive motion of the articulation was permitted with- out pain. The patient was in bed. Buck's extension was applied to the limb, and the question arose: What shall be done ? It was deemed best to continue the traction for a few days. This was done, and the patient then was pcj'initted to get up. As mentioned in the notes, all the hip symptoms dis- appeared under this treatment, and the trouble concentrated about the knee joint ; and this complication did not yield prior to the discharge of the patient. The manner in which recovery was effected is very suggestive of the methods employed by the professional bone-setters.