Lectures on orthopedic surgery and diseases of the joints : delivered at Bellevue Hospital Medical College, during the winter session of 1874-1875 / by Lewis A. Sayre.

  • Lewis Sayre
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on orthopedic surgery and diseases of the joints : delivered at Bellevue Hospital Medical College, during the winter session of 1874-1875 / by Lewis A. Sayre. Source: Wellcome Collection.

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    of undue nervous irritation from genital excitement, which has resulted in partial paralysis of the lower extremities, and in con- sequence of this partial paralysis the deformity has been devel- oped. This subject of nervous irritation and consequent exhaustion from undue genital excitement is one of a vast deal of impor- tance, and has not received the attention at the hands of the pro- fession that it justly deserves. The pressure continually exerted upon the glans penis by the contraction of the adherent prepuce keeps the organ in an almost constant state of irritation and erec- tion. Such a constant genital excitement, no matter what its cause may he, whether occurring in a child or in an adult, is certainly detrimental to the best condition of the nervous system. In the class of cases before us, this undue genital excitement ends in paralysis, and the consequent deformity varies according to the manner in which the weight of the body is placed upon the foot. A simple mechanical support will restore the foot to its normal position, but the child can only be relieved permanently of the deformity by removing the cause which has given rise to the paralysis. The first step, then, to be taken toward curing this case is to perform the operation of circumcision, and liberate the glans penis from the adherent prepuce; for I am firmly of the opinion that the paralysis in this case is the result of nervous irri- tation from genital excitement which is caused by this adherent prepuce. [The operation was performed.] The child will be re- turned at the end of two weeks, and we shall then see whether any benefit has been derived from the operation. Meanwhile, no dressing whatever will be applied to the distorted feet, in order that we may see what effect this nervous affection had in producing the deformity.1 2 1 The mother returned at the end of the two weeks, stating that the child had been perfectly quiet every night since the operation, sleeping without any disturbance, and passing his water without difficulty, which had never occurred before. He ate veil, was very much improved in his general appearance, and could stand flat on his feet without any assistance. Upon stripping the child’s feet the mother’s statement vas fully corroborated, as will be seen by the annexed figure (Fig. 1), which was taken immediately after by Mr. Mason, photographer to Bellevue Hospital, just two weeks from the operation. As will be seen, the child stands perfectly flat upon the feet, with simple inversion of the great-toe of the left foot. The increased muscular power without the use of any electricity has been almost marvelous, and now by the 2