Anomalies and Curiosities of Medicine [416]
and in November the plaster-of-Paris jacket was removed, and he propelled himself about the ward in a rolling chair, and shortly after was able to get about slowly on crutches. He was discharged December 23d, and when I saw him six months later he walked very well and without effort; he carried a cane, but this seemed more from habit than from necessity. At present date he weighs 150 pounds, and drives a huckster wagon for a living, showing very little loss of motion in his lower extremities."
Although few cases show such wonderful improvement as this one, statistics prove that the results of this operation are sometimes most advantageous. Thorburn collects statistics of 50 operations from 1814 to 1885, undertaken for relief of injuries of the spinal cord. Lloyd has compiled what is possibly the most extensive collection of cases of spinal surgery, his cases including operations for both disease and injury. White has collected 37 cases of recent date; and Chipault reports two cases, and collected 33 cases. Quite a tribute to the modern treatment by antisepsis is shown in the results of laminectomy. Of his non-antiseptic cases Lloyd reports a mortality of 65 per cent; those surviving the operation are distributed as follows: Cured, one; partially cured, seven; unknown, two; no improvement, five. Of those cases operated upon under modern antiseptic principles, the mortality was 50 per cent; those surviving were distributed as follows: Cured, four; partially cured, 15; no improvement, 11. The mortality in White's cases, which were all done under antiseptic precautions, was 38 per cent. Of those surviving, there were six complete recoveries, six with benefit, and 11 without marked benefit. Pyle collects 52 cases of spinal disease and injury, in which laminectomy was performed. All the cases were operated upon since 1890. Of the 52 cases there were 15 deaths (a mortality of 29.4 per cent), 26 recoveries with benefit, and five recoveries in which the ultimate result has not been observed. It must be mentioned that several of the fatal cases reported were those of cervical fracture, which is by far the most fatal variety.
Injury to the spinal cord does not necessarily cause immediate death. Mills and O'Hara, both of Philadelphia, have recorded instances of recovery after penetrating wound of the spinal marrow. Eve reports three cases of gunshot wound in which the balls lodged in the vertebral canal, two of the patients recovering. He adds some remarks on the division of the spinal cord without immediate death.
Ford mentions a gunshot wound of the spinal cord, the patient living ten days; after death the ball was found in the ascending aorta. Henley speaks of a mulatto of twenty-four who was stabbed in the back with a knife. The blade entered the body of the 6th dorsal vertebra, and was so firmly embedded that the patient could be raised entirely clear of the bed by the knife alone. An ultimate recovery ensued.
Although the word hernia can be construed to mean the protrusion of any viscus from its natural cavity through normal or artificial openings in the surrounding structures, the usual meaning of the word is protrusion of the abdominal contents through the parietes--what is commonly spoken of as rupture. Hernia may be congenital or acquired, or may be single or multiple--as many as five having been seen in one individual. More than two-thirds of cases of rupture suffer from inguinal hernia In the oblique form of inguinal hernia the abdominal contents descend along the inguinal canal to the outer side of the epigastric artery, and enter the scrotum in the male, and the labium majus in the female. In this form of hernia the size of the sac is sometimes enormous, the accompanying illustration showing extreme cases of both scrotal and labial hernia. Umbilical hernia may be classed under three heads: congenital, infantile, and adult. Congenital umbilical hernia occurs most frequently in children, and is brought about by the failure of the abdominal walls to close. When of large size it may contain not only the intestines,
Although few cases show such wonderful improvement as this one, statistics prove that the results of this operation are sometimes most advantageous. Thorburn collects statistics of 50 operations from 1814 to 1885, undertaken for relief of injuries of the spinal cord. Lloyd has compiled what is possibly the most extensive collection of cases of spinal surgery, his cases including operations for both disease and injury. White has collected 37 cases of recent date; and Chipault reports two cases, and collected 33 cases. Quite a tribute to the modern treatment by antisepsis is shown in the results of laminectomy. Of his non-antiseptic cases Lloyd reports a mortality of 65 per cent; those surviving the operation are distributed as follows: Cured, one; partially cured, seven; unknown, two; no improvement, five. Of those cases operated upon under modern antiseptic principles, the mortality was 50 per cent; those surviving were distributed as follows: Cured, four; partially cured, 15; no improvement, 11. The mortality in White's cases, which were all done under antiseptic precautions, was 38 per cent. Of those surviving, there were six complete recoveries, six with benefit, and 11 without marked benefit. Pyle collects 52 cases of spinal disease and injury, in which laminectomy was performed. All the cases were operated upon since 1890. Of the 52 cases there were 15 deaths (a mortality of 29.4 per cent), 26 recoveries with benefit, and five recoveries in which the ultimate result has not been observed. It must be mentioned that several of the fatal cases reported were those of cervical fracture, which is by far the most fatal variety.
Injury to the spinal cord does not necessarily cause immediate death. Mills and O'Hara, both of Philadelphia, have recorded instances of recovery after penetrating wound of the spinal marrow. Eve reports three cases of gunshot wound in which the balls lodged in the vertebral canal, two of the patients recovering. He adds some remarks on the division of the spinal cord without immediate death.
Ford mentions a gunshot wound of the spinal cord, the patient living ten days; after death the ball was found in the ascending aorta. Henley speaks of a mulatto of twenty-four who was stabbed in the back with a knife. The blade entered the body of the 6th dorsal vertebra, and was so firmly embedded that the patient could be raised entirely clear of the bed by the knife alone. An ultimate recovery ensued.
Although the word hernia can be construed to mean the protrusion of any viscus from its natural cavity through normal or artificial openings in the surrounding structures, the usual meaning of the word is protrusion of the abdominal contents through the parietes--what is commonly spoken of as rupture. Hernia may be congenital or acquired, or may be single or multiple--as many as five having been seen in one individual. More than two-thirds of cases of rupture suffer from inguinal hernia In the oblique form of inguinal hernia the abdominal contents descend along the inguinal canal to the outer side of the epigastric artery, and enter the scrotum in the male, and the labium majus in the female. In this form of hernia the size of the sac is sometimes enormous, the accompanying illustration showing extreme cases of both scrotal and labial hernia. Umbilical hernia may be classed under three heads: congenital, infantile, and adult. Congenital umbilical hernia occurs most frequently in children, and is brought about by the failure of the abdominal walls to close. When of large size it may contain not only the intestines,