Accident and injury : their relations to diseases of the nervous system.

  • Pearce Bailey
Date:
1900
Catalogue details

Licence: Public Domain Mark

Credit: Accident and injury : their relations to diseases of the nervous system. 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.

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    operative treatment. That the subject has been, and still is, treated with less attention than it deserves, there is, un- fortunately, no question of doubt. Injuries to the spinal cord are as old as the art of medicine itself; yet it is only within the last decade that there has arisen any definite knowledge as to the localization of function of the spinal- cord segments. Such knowledge as we now possess is largely due to the study of traumatic cases. In many cases of traumatic nervous disease the clinical picture is so plain that a cursory examination suffices for an immediate and correct appreciation of the cause, the nature and the probable outcome of the injury. The ambulance surgeon can often diagnosticate a fracture of the spine from the seat of the ambulance, and fractures of the skull are of so common occurrence in emergency hospitals that experi- enced surgeons recognize the condition by the general ap- pearance of the patient alone. Yet from the organic lesions of the nervous system, whose nature is readily apparent, to those which require the closest study and rarest skill for their diagnosis, is not so very long a step. In presumable brain injuries, when the patient is comatose or delirious, examination for localizing signs is often unsatisfactory, and the history of the accident may be unobtainable, or if told by witnesses unreliable, so that the diagnosis of fracture of the skull or laceration of the brain, as opposed to some of the idiopathic forms of coma, is very difficult or at times even impossible. In the diagnosis of the puzzling forms of traumatism of the back—as a result of which, without evidences of lesion to the vertebras, there are selective symptoms of injury to the spinal cord—considerable knowledge of the anatomy and pathology of the nervous system is often necessary. This fact becomes evident upon the perusal of the works of Erichsen, the pioneer in traumatic neurology, who failed to recognize the true condition in many cases of back injury.
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