Cases of paraplegia / by T. Grainger Stewart.

  • Stewart Thomas Grainger, Sir, 1837-1900.
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: Cases of paraplegia / by T. Grainger Stewart. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    weather was cold and damp. The legs felt cold, but were free from pain, formication, or numbness. The sensibility to all kinds of impressions was normal. The reflex action produced by ticklinjj; the feet was rather exaggerated. Voluntary motion was impaired in the legs, especially in the right one. When lying in bed some slight and feeble movements could be accomplished, but when he attempted to stand the power gradually passed away, and in a few seconds he fell. It was impossible for him to walk. The muscles of the legs were fairly nourished. Their electro-contractility was normal, but they were frequently disturbed by involuntary spasmodic jerkings. There was an acute curvature of the spine at the level of the seventh or eighth dorsal vertebra; but there was no sign of abscess in connexion with it, and the patient was free from fever. The diagnosis in this case was obvious, viz., paraplegia, due to pressure exerted upon the anterior columns of the cord by the bag of debris resulting from the destruction of the bodies of the vertebrse. The treatment adopted was rest, which was obtained by remain- ing in bed, and by using a mechanical suppoi't wlienever the ]iatient assumed the erect posture; the administration of cod-liver oil and of iron ; and the regular faradization of the nerves and muscles of the legs. The instrument for support was constructed by Mr Gardner, and was designed to take the weight of the shoulders and head off the spine. It consisted of a firm girdle base, resting upon the sacrum and the iliac bones ; from each side there arose a steel rod, terminating in a crutch, which reached the axilla. By this means the weight of the shoulders was conveyed directly to the pelvis. From the centre of the sacral part there sprang a rod which curved forwards at its upper extremity, so as to sup- port the head by means of a strap which passed below the chin. Whenever the instrument was put on, the patient felt some relief of the pain in the back, and some increase of power in the limbs. He gradually improved, and by the middle of June not only walked about the ward, but made his way down to the green; and by November he was quite well, excepting that an anchylosed curvature existed in the back. After thus recovering his health he went to sea, and remained steadily at work until about Christmas 1874, when his ship was overtaken by a storm and dismasted. He was then obliged, like the rest of the crew, to make great exertions to prevent the rise of water in the hold, and to work hard at the pumps for fifty-two hours with very little intermission. The ship was saved, but his spinal pains returned, and paraplegia speedily supervened. He was treated in hospital at Wexford for a fortnight; was then transfeiTcd to another intirmary, where his symptoms gradually increased, until, in the month of April, he was dismissed as incurable. He then returned to Edinburgh on 24th April 1875, was readmitted to my wards, and examined. It was then found that the girdle pain was