The supposed curative effect of operations per se / by J. William White.

  • White, J. William (James William), 1850-1916.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: The supposed curative effect of operations per se / by J. William White. 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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    t CI'RATIVE EFFECT OF OPERATIONS PER SE. x9 possibly much of the good effected by trephining in traumatic cases might be brought about with equal certainty and more safety merely by raising the portion of the scalp containing the cicatrix. This I have done in some very recent cases, with the usual result of a temporary disappearance of the convulsions. The accidental cures of epilepsy, 13 instances of which are included in the table, and the cases of relief from fixed pain af- forded by simple trephining, are almost equally striking in the absence of any comprehensible relation between the trauma- tism and the disappearance of symptoms. Passing from the cerebral to the spinal region, I will cite only one illustiative case. A male patient, aet. 55, was attacked Decembei 25, 1887, with severe pains in his arms and shoulders; three or four days later there was weakness of the thighs, spreading rapidly down the legs to the feet, and upward to the nipple line. In eight days there was absolute paralysis of the parts involved, in- cluding both sphincters, while at the same time the paralyzed parts became the seat of profound anaesthesia. Girdle pains developed, bed sores made their appearance; percussion of the spine over the third and fourth vertebrae became painful; the reflexes were exaggerated, and slight blows on the head in the direction of the spinal axis gave rise to frightful exacerba- tions of the girdle pain. These symptoms developed and in- creased in severity for ten months; all internal therapeutics were exhausted, and it was finally decided to trephine the spine, although one distinguished neurologist was positive we were dealing with a case of Landry’s paralysis and that opera- tion was unjustifiable. Dr. Dercum, in whose practice the case occurred, agreed with me that an exploratory operation was indicated, and I, accordingly, on October 17, 1888, re- moved the spines and laminae of the first five dorsal vertebrae, opened the slightly thickened dura, separated some firm adhe- sions to the subjacent pia mater, explored the cord with my finger, and then having quite failed to discover any serious pathological changes, closed the wounds in the dura and soft parts. The girdle pain had entirely disappeared by the fol- lowing day, sensation began to return in the feet the day after,