The hysterical element in orthopædic surgery / by Newton M. Shaffer.

  • Shaffer, Newton M. (Newton Melman), 1846-1928.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: The hysterical element in orthopædic surgery / by Newton M. Shaffer. 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.

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    nothing of importance in his early history,—he had always been a healthy, though not a rugged boy. In February, 1878, the patient fell upon the^ ice in front of his home, striking upon his knee-joint. The injury was quite severe and the boy was carried into the house. There was great pain, followed by ecchymosis and some heat and swelling. These symptoms continued for a few days, and after their most acute phase subsided, there was more or less pain on moving the joint, with swelling at the point of injury. He remained in bed for five weeks, and for the two or three weeks following he was dressed, but hobbled around saving, in every possible way, the affected joint. Finally, about ten weeks after the injury he walked as well as ever, and during the spring and summer walked to and from school daily, a distance of four miles. On October loth, he went on an errand for his mother, and on his return his knee pained him very much and he was obliged to stop walking. After this, he hopped around, always holding the leg flexed on the thigh in one position. From October loth to November 25th, (the day he consulted me), he had not been out of doors, except to come to the city. 'Inhere had been no acute pain in the joint when it was at rest, but any sudden motion produced sharp pain : he had slept tolerably well ; there was considerable atrophy of the thigh and the leg muscles and the boy was thin and anaemic and, evidently, very apprehensive about his knee. The joint was held quite rigidly by muscular action in tine extremes of flexion and extension, but examination proved that no real muscular spasm existed : the joint could be flexed and extended normally by persistently using a very moderate degree of force, though the attendant states that the position of the leg was not modified during sleep. The patient gave a history of mental overwork : had studied hard and for several years : tastes had always been effeminate—al- ways very gentle in his play, preferring the society of girls to that of boys of his own age ; not emotional as to tears, but is what would be called a nervous boy. Remarks.—My comments on this case will consist simply of extracts from the letter which I sent to the family physi- cian : I may summarize the results of my examination as follows:—no marked pain on motion which was not limited by any reflex muscular spasm, though the spasm was closely