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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    results obtained in many of liis cases were very remarkable. He formed issues, kept them open with peas, and irritated the surface from time to time with powder of cantharides. It appears probable that counter-irritation is of use in different ways, viz., in relieving pain, in cheeking inflammatory action in the articular form of spine disease, and in diminishing inflammation of the membranes and substance of the cord. The experience of Charcot is much in favour of it. He employs the actual cautery. Of tlie benefits to be ob- tained by blisters and setons, we have an example in a case recorded by Dr James Young^ about twenty years ago ; while the applica- tion of compound tincture of iodine is recommended by Mr Shaw,* writing in Holmes's System of Surgery. The results obtained by our treatment in the first illness have been already referred to. What were the results obtained during the second period ? The spine became once more anchylosed ; the membranes and the cord were restored almost to theii- natural condi- tion, and the occurrence of important secondary changes (consecutive sclerosis) was prevented. That recovery of wounded or injured spinal cord may take place, was proved by the observation of Van Kempen, Flourens,^ Brown-S(?quard,* Masius and Vanlair.^ The last-named authorities proved not only that simple section of the cord of the frog, or other animal, may be recovered from, but that a considerable loss of substance may be made up for, and voluntary motion completely restored. The details of the pathological process, as described by these writers, are full of interest. Leyden states that experiments have been made by Paul Dentan, which show that this power of recovery exists in dogs as well as in cold-blooded animals. Such observations render it probable that, even in man, there may be restoration of structure as well as function where lesions have been produced by injury or disease; and, unless I am mistaken, this actually occurred in our patient. Recovery from the local affection being obtained before much time had elapsed, he was saved from the development of secondary sclerosis. Case II, Paraplerjia with ancesthesia, intense neuralgia, and wast- ing of mtoscles, follotoing upon fatigue, exposure to cold, and malarious poisoning. Treatment hy Opiates and Quinine. Recovery. Mr A. B. jSrst consulted me on 28th October 1874. He was then twenty-four years of age, had always been healthy, but led a some- what intemperate life as he grew into manhood. He married before he was twenty, and went to America, where he entered upon prac- tice as a veterinary surgeon. ' Edinburgh Medical Journal, 1856, p. 1021. * Holmes's System of Surgery, 2d edition, vol. iv. p. 158. ■■' Annates des Sciences Naturelles, t. 13, p. 128. * Med. Exam., 1852, p. 379. * Recherches Experimcntelles suv la Rdg^ndration Anatomitiue et Function- file de la Moelle Epini&re. Quoted by Leyden. Leyden, op. cit., vol. i. p. 84.