Ankylosis, hypertrophy, and extreme lateral curvature of the cervical and upper dorsal vertebrae following acute rheumatism, successfully treated by mechanical means ; Complete amputation of male genitals for recurrent epithelioma / under the care of Robert Jones.

Robert Jones

Date:: [1887]

Credit: Ankylosis, hypertrophy, and extreme lateral curvature of the cervical and upper dorsal vertebrae following acute rheumatism, successfully treated by mechanical means ; Complete amputation of male genitals for recurrent epithelioma / under the care of Robert Jones. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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$been an inmate for a little over two months. At the time of his discharge he had very complete voluntary power over extension and flexion, and could bring his chin opposite the sterno-clavicular notch, and rotate it upwards of four inches to the left. On his return to Ripon he was taken ill, and failed to con- tinue his exercises, so that, on his re-admission into the Stanley Hospital, On April 9th, his radius of rotation was much diminished. Under proper treatment, however, he soon im- proved, and, on his discharge pre- sented the appearance delineated in Fig. 4. This case seemed to be very hopeless at first; but, after consultation with my colleagues, Messrs. Sheldon and Smith, it was decided that a mode of treatment should be adopted which would in no way jeopardize the patient’s safety; the leverage used was con- sequently of a very harmless kind. The patient’s impaired articulation and respiration, apart altogether from the hideous and painful characters of the deformity, proved the urgent necessity for remedial action. The principle which underlies the treatment of deformities of t\iis type consists in maintain- ing any advantage gained; hence the value of stocks and. wedges. Manipulative exercises without this precaution are simply useless. As soon as the position of the neck is improved ever so slightly, wedge it in that position, so that it cannot gravitate into the old deformity. I have mentioned that the upper dorsal vertebrae were aukylosed. They were also slightly incurvated, the right shoulder being about three inches higher than the left. When the patient was told to stoop, none of the spinous processes of the aukylosed vertebra projected, a symptom I have on other occassions witnessed and pointed out. I have to thank Dr. Owen for the interest$