The necessity of recognizing 'reflex spasm' produced by point pressure in contractured tissues : and of making proper division of the same before any mechanical treatment can be effectual / by Lewis Hall Sayre.

  • Sayre, Lewis Hall.
Date:
[1886]
Catalogue details

Licence: Public Domain Mark

Credit: The necessity of recognizing 'reflex spasm' produced by point pressure in contractured tissues : and of making proper division of the same before any mechanical treatment can be effectual / by Lewis Hall Sayre. 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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    by recognizing the importance of the “ reflex spasm” pro- duced by “point pressure” in contractured tissues, their proper division, and replacement of the parts in the normal position at the time of operation, and retention during the time the divided tissues are re-uniting, thus preparing the way for appropriate after-treatment, which will in many cases yield most gratifying results, without trouble or annoy- ance to the surgeon, or causing the patient any pain or in- convenience. The following cases illustrate the advantage of recogniz- ing the doctrine above inculcated : Case I.—L. S., aged 8, only child of healthy parents, when a little more than a year old, had a slight convulsion, followed by high fever, and resulted in complete paralysis. From this she recovered to a great extent, although she has indistinct articulation, and imperfect use of the arms and legs. Both feet are varo-equinus. The tendo-achilles and plantar fascia of both feet give a reflex spasm on point pressure. Since she was 4 years of age, she has been under constant medical at- tention, and has had the feet manipulated and rubbed, and has worn braces of different varieties, but there has been no change in the deformity. On January 27th, 1886, the tendo-achilles and plantar fas- cia of both feet were divided subcutaneously, and the feet restored to their normal position immediately after the ope- ration, and retained there by foot-board and usual dressing. She suffered no inconvenience after the operation, and on February 8th, the dressings were removed, the feet being in their proper position, and the wounds entirely healed. Can stand and walk with feet flat upon the floor. Is to contiuue massage and electricity. No braces were applied. March 8th.—Patient returned. Has improved more since the operation than in all the years previous. Case II.—C. G., set. 14, strong, healthy boy, of good family history. When 2 years of age, he had a fall, resulting in pa- ralysis of the right limb and part of the trunk; also bladder and rectum. The bladder and rectum recovered their power in a few days, and some months afterwards he began to walk, but did not put the heel of the foot to the ground, walking on the anterior part of the foot (talipes equinus). He was treated at this time by manipulation, and improved. But the foot could not be brought to a right angle with the leg; and as he grew older the deformity increased. He has