Case of fracture of the spine, in which the operation of trephining was performed : with observations / by Robert M'Donnell.

  • McDonnell, Robert, 1828-1889.
Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: Case of fracture of the spine, in which the operation of trephining was performed : with observations / by Robert M'Donnell. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    CASE OF FRACTURE OF THE SPINE, IN WHICH THE OPERATION OF TREPHINING WAS PERFORMED, WITH OBSERVATIONS. Unsuccessful cases are often more instructive to the practical surgeon than those which terminate favourably; with reference to the subject which I propose to discuss in the following pages this is strikingly true, for I cannot help believing that thoughtful persons will be led to look favourably upon the operation of trephining the spine in certain cases of injury, as much from a careful consideration of some of the cases in which this operation has failed to save life, as from the account of those in which life has been actually saved by it. It must be admitted that the question as to the judiciousness of trephining the spine, with a view to remove pressure from the spinal marrow, is one of the nicest which can be presented to the surgeon; and we know that surgeons of the greatest eminence are to be found ranged on both sides of the controversy—a controversy which, I regret to say, has not always been carried on with the calmness which should characterize such debates. Before myself determining to recommend this operation, or to perform it if a suitable case should occur in my practice, I had very carefully studied what has been written both for and against it, and, so far as was possible, I had examined accurately the details of the published cases in which the operation had been performed. After due deliberation I had come to the conclusion that even on 'purely theoretic grounds, and viewed by the light which modern physiology and physiological experiment throw upon the subject, the weight of evidence lay on the side of those who, with Sir Astley Cooper at their head, advocate the operation. But in the advancement of surgery everything is essentially tentative, and results of cases must be the true criteria by which the most plausible theories are to be tested. An analysis of these results appears to me to lead irresistibly to the conclusion that in many instances this operation is good surgery; but in attempting to form a just appreciation of the value of the results of these cases, I do not intend to refer simply to those in which life seems to have been saved by the operative procedure; in not a few of the cases, w^hich ultimately ran a fatal A