Caries of the spine : being an advance chapter of The spine its deformities, debilities, and deficiencies (third edition now in press) / by Heather Bigg.

  • Bigg, Henry Robert Heather, 1853-1911.
Date:
1902
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Licence: In copyright

Credit: Caries of the spine : being an advance chapter of The spine its deformities, debilities, and deficiencies (third edition now in press) / by Heather Bigg. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    to. tlie operation, I put myself in communication with the distinguished originator of the operation, and saw the case in consultation with him at the Langham Hotel. He, after a careful examination, immediately decided on the wisdom of the operation, and arranged a time for the boy to come up again to town for the purpose. The operation having been satisfactorily recovered from, the boy was kept recumbent til] December, after which he was allowed to sit up against a cushion for part of the day. In March, 1900, a splint was applied similar to the one with which I had treated the earlier stages of the disease. When I last saw the boy, March, 1901, he could stand by supporting himself against a piece of furni- ture, and although his ankles were flail-like in weakness, there was no rigidity nor contraction whatever. In short, the operation had cleared the cord and eliminated the rigid result of its embarrassment. Now if the history of this case be compared with that of the previous one, it will at once be seen Avhat is gained by operative intervention at the right moment. Of course in cases where the limbs make a balanced recovery of their power without any appearance of contraction or rigidity, then operative interference is unneeded. But this is not usually the case, and when I consider how terrible is the condition of the patient where the recovery of power is attended with contractions at every joint of the limbs, and where efforts at walking are painful and laborious over a long series of years, I cannot but conclude that laminectomy performed as soon as any contractions or rigidity set in, is the right and proper course to pursue, always provided that its performance is not prohibited by any grave contra-indications. Meningitis.—This has been said by some authors to occasionally cause a fatal ending to a case of caries, the in- flammatory processes extending from the seat of the disease to the membranes of the cord and brain. I have only ever, in private practice, seen one such case, and even that was a doubtful one. The patient, a tuberculous-looking housemaid of the age of eighteen, was brought to me from the country in January, 1894, by her master, who was a patient of mine. He said the girl had a stiff wry neck. Her history was