A contribution to the surgery of the spinal cord.

  • Thorburn, William, Sir, 1861-1923.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: A contribution to the surgery of the spinal cord. 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.

    232/246 (page 220)
    On these grounds,, then, there appears to be the closest pos- sible connection between traumatic hysteria and the jDaralysis of hypnotic suggestion, and on these grounds we must, I think, accept the theory of Charcot. If we attempt to go further, and to inquire into the material basis of hysteria, we find ourselves almost hopelessly without the guidance of facts, and we pass, moreover, to the consideration of questions, which, as they relate to all varieties of hysteria, and by no means to the traumatic form only, I do not intend now to discuss. Suffice it to say that the change is almost certainly cortical, and is probably associated with an anaemia of one side of the cortex, possibly with a correlated hypertemia of the other. 6. Prognosis. ]\Iy own experience, relating, as it does, mainly to isolated examinations, hardly furnishes, if taken alone, sufficient grounds for any definite conclusions on this most difficult of questions; nor do we find in current literature any very satisfactory data; but a comparison of experience with previous observations is not altogether without value. Whereas some writers refer to these cases as practically incurable, others speak of them as almost invariably recovering with rapidity, and on both sides we find opinions expressed with a perhaps somewhat unwarrantable dog- matism. The main reason of this discrepancy would appear to be that the question of pecuniary compensation enters in a varying degree into relationship with the cases observed by different authors. Before we can arrive at any definite decision, we must endeavour to divest ourselves of this source of confusion. Looking to our o^ti cases, we find three only in which there was no such question (Cases 53, 54, and 57). These were all treated in hospital, and had all been previously neglected. Before they came into hospital they either manifested no tendency to im- provement, or were getting distinctly worse. In hospital, on the other hand, the improvement was rapid and obvious. Un- fortunately, the exigencies of public practice do not allow of their being retained sufficiently long for the completion of a cure, but we can hardly doubt that a more prolonged sta}' would suffice to produce this result, and these cases seem strongly to suggest the probability of a complete cure within, at most, a few months, inovided the conditions he satisfactory. Most instructive in this connection are the following cases recorded by Mr. Collier ('). Briefly, these are as follows :—