Surgical experiences : the substance of clinical lectures. / By Samuel Solly.

  • Samuel Solly
Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: Surgical experiences : the substance of clinical lectures. / By Samuel Solly. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    inflammation of tlie anterior and posterior ligaments of the spine, or the intervertebral substance, wliich, if mi- checkecl, goes on to ulceration, not merely of the fibro- cartilages, but of the bones themselves. Such serious consec|[uences do not often follow strains in strong healthy persons, but only in individuals of lax muscular fibre. This severe injury of the ligamentous connections of the vertebral column, takes place in consequence of the spinal muscles, whose office I described in my former lecture, under the title of “ intelligent ligaments,” not performing their duties efficiently. From deficient mus- cular power, a greater strain is thrown upon the spinal ligaments than they can bear. You must not, then, confound inefiicient muscular action, arising from gene- ral want of ]DOwer, with the strumous or scrofulous diathesis. The following case, which I saw at home, on Thursday last, the 3rd instant, illustrates the kind of injury which is very likely to lead to disease of the intervertebral substance if it be not checked ;— Rebecca Warland, aet. 42, married woman, wife of a brewer, bas always lived well, but not to excess; appearance rather delicate, but not unhealthy; has had seven children, and five living, the youngest seventeen months old; she nursed until it was five months old. Applied to me at home on account of a pain in her back and loins, which is constant, and a most distressing sensation on stoop- ing. She attributes her present symptoms to a fall, exactly a week ago, in coming downstairs, when she slipped, and falling partly over the bannisters, twisted her spine. She suffered most acute pain at the time, Avhich has never left her altogether since, but has rather increased. She feels a twitching of the legs while walking, and a catching- in her back, which, she says, causes her to di-aw up her right leg. The pain she experiences in her back is pi-incipaUy on the right side. The spine is thi-oughout tender to the touch; but she suflers acutely if it is tapped over the fourth lumbar vertebra, which was the exact seat of the pain at the time of the accident. As she is falhng off to .sleep at night, she is awoke with twitclungs and catch- ings of the legs and back pai-t of the head, and when thus roused, she is not collected immediately on awaking, as she always was previous to the accident, but is confused and bewildered. In the daytime, if she stoops her head, she feels giddy and loses her memory. Tongue white, and slightly furi-ed ; pulse 68, soft; bowels as usual, rather confined. Ordered—Cal. c. Rhei, gr. xv. ; Cue. Crueut. Lumbis ad ^viy-