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Alternating stepping reflex - a reflex of the lower limbs where the whole lower limb moves in a step Anuria - a condition in which no urine is voided Ataxia - loss of coordination Atlas - the first cervical vertebra Autonomic dysreflexia - a reflex of the cardiovascular system resulting in high blood pressure when the bladder or other organ is stimulated Bradycardia - slow heart beat Calvaria - the skull cap or vault of the head Cauda equina - a collection of nerve roots from the lumbar sacral and coccygeal spinal nerves that run down inside the spinal column until they leave through their respective openings Cervical- neck. Clonus - a succession of intermittent muscular relaxations and contractions Closed reduction - manipulation of the vertebral column usually under an anaesthetic without opening Compression fracture - the front-part of a vertebral body is compressed to half or less of its normal height Conservative treatment of a spinal injury - just leaving the vertebral column to unite in any position Computed tomography (CT) can distinguish soft tissues from cysts or fat Continuous catheterisation - leaving the catheter in situ continuously to drain the bladder Contracture - the abnormal fixation or limitation of range of any joint, caused by muscle imbalance, muscle shortening as a result of bad positioning or insufficient physiotherapy. Cordotomy - the surgical operation of cutting the antero-Iateral tracts of the spinal cord to relieve otherwise intractable pain Crura cerebri - part of the brain Cystitis - inflammation of the bladder Cystogram - x ray picture of the urinary bladder with contrast media Cystotomy - cutting into the urinary bladder Decubitus ulcers - bed sores Dermatome - skin segment corresponding to a nerve supply 281 282 Glossary

Detrusor contraction - reflex contraction of the bladder Dislocation - of vertebrae may occur without fracture (especially in the cervical spine) but is usually combined with fractures at all levels of the spine. Vertebrae may be displaced backwards, forwards or sideways. Dorsal- upper back. Also called thoracic. Dysphagia - difficulty in swallowing Dyspnoea - difficulty in breathing Epiphysis - the spongy extremity of a bone, attached to it for the purpose of forming a joint with the similar process of another bone Erysipelas - a disease characterised by diffuse inflammation of the skin and fever. Eschar - a piece of the body killed by heat or caustics Excision of sore - The black and greenish necrotic tissue covering the depth of the sore is excised. Intact skin and bleeding granulations are preserved. Expression - method of emptying the bladder by compressing the abdominal wall Fistula - an unnatural narrow channel leading from some natural cavity to the surface or a communication between two cavities where none should exist Flaccid - The form of paralysis of muscle in which it loses all tone. Reflexes are absent. Fracture-dislocation - in addition to compression of the body of a vertebra, there is also dislocation of one vertebra relative to another with tearing of ligatures and sometimes fracture of the bony walls of spinal canal Gibbus - deformity of the spine Haematomyelia - blood in the spinal cord Haematuria - blood in the urine Haemoptysis - the spitting up of blood from the lower air passages Hemiplegia - paralysis limited to one side of the body Heterotopic calcification - abnormal calcification around joints and bones in paralysed parts of the body Hyperaesthesia - oversensitiveness of a part Hypertropby - the increase in size of an organ as the result of an increased amount of work demanded of it by the body Hypoglossal- 12th cranial nerve Ileus - stoppage of peristalsis due to paralysis of the bowels Inanition - exhaustion through lack of food Incomplete lesion - paraplegia due to partial damage of the spinal cord in which, below its upper level, there are remnants of active movement or sensation. Intermittent catbeterisation - placing a catheter in the bladder at regular intervals, draining the urine and then removing the catheter Intravenous pyelogram (lVP) - a procedure for getting x rays of the urinary tract by injection of contrast medium intravenously Laminectomy - Neurosurgical operation in which selected spinous processes and part of the laminae of vertebrae are removed and the spinal canal opened from an incision on the back. Lesion - general term for damage to the spinal cord. Level of a lesion - The upper limit of the paralysed area, described according to the uppermost segment of the cord involved. Lumbar - lower back Luxation - another name for dislocation MRI - Magnetic Resonance Imaging Mass reflex - reflex of the whole of the paralysed part of the body, described by Head Meteorism - the distension of the abdomen by gas produced in the intestines (flatulence) Glossary 283

Microcephaly - abnonnal smallness of the head Myelography - injection of a radio-opaque substance into the cerebrospinal fluid of the spinal cord to assist in diagnosis Nephrosis - The chronic form of kidney damage due to either vascular disease or persistent infection Open reduction - open reduction of the vertebral column usually under anaesthetic Osteomyelitis - Infection and creeping destruction of bone underlying neglected pressure sores. Papillitis - inflammation of any papilla Paraparetic - partial paralysis Paraplegia - paralysis of the lower limbs [Greek] Paresis - a state of partial paralysis Periosteum - the membrane surrounding a bone Polyuria - excessive urine Postural reduction - reducing the fracture by manipulation Pott's disease - the angular curvature of the spine which results from tuberculous disease Priapism - erection Pyaemia - a fonn of blood poisoning in which abscesses appear in various parts of the body Pyelonephritis - inflammation of the kidney Pyuria - Pus in the urine Quadriparetic - paralysis of all four limbs [Latin] Reflux - Nonnally the ureter is a one way passage, pumping urine from the kidneys into the bladder. In certain conditions bladder pressure causes urine to run back up the ureter. Rhizotomy - the surgical operation of cutting a nerve root, for example, to relieve pain Sagittal- the term applied to a structure or section running from front to back in the body Somatic - relating to the body as opposed to the mind Sphincter ani - anal sphincter Spinal shock - the initial stage after injury to the spinal cord in which all function ceases in the cord below the level of the lesion. Sten!)sis - unnatural narrowing in any passage or orifice of the body Suprapubic catheterisation - catheters are passed into the bladder via an incision in the lower abdominal wall to allow urine to drain or wash out an infected bladder Surgical treatment of a spinal injury - placing the vertebrae in alignment under an anaesthetic and possibly fixing them Synergist - a muscle that works in concert with an agonist muscle to perfonn a certain movement Syringomyelia - a rare disease affecting the spinal cord in which are found irregular cavities surrounded by an excessive amount of connective tissue of the central nervous system. Tabes dorsalis - locomotor ataxia Tetraplegia (also known as quadriplegia) - paralysis of all four limbs [Greek] Theca - a sheathlike structure enclosing the brain and spinal cord Tidal drainage - method for giving continuous bladder washouts with antiseptic solution Traction - used with skull callipers to reduce and maintain in alignment fracture-dislocations of the cervical spine Uraemia - the clinical state that arises from renal failure Urethritis - inflammation of the urethra About the Author

John Russell Silver was born in London in 1931. His father was a general practitioner who later specialised in psychiatry. John Silver received his schooling at University College School, Hampstead, and trained in medicine at the Middlesex Hospital. He graduated in 1954 and after two house jobs worked as a registrar for Sir Ludwig Guttmann for a year at the National Spinal Injuries Centre. During this time he worked for a spell in the Hungarian refugee camps after the 1956 revolution. After his National Service in orthopaedics in the Royal Air Force, he continued his training in spinal injuries spending 3Y, years in the neurology, neurosurgery and physiology departments of the Middlesex Hospital. He returned to the National Spinal 'Injuries Centre for 3 years in a research post until appointed consultant in charge of the Liverpool Centre and Lecturer in Surgery in 1965. In 1970 he returned to Stoke Mandeville as a consultant in spinal injuries during which time he served as Chairman of the Division until he retired from clinical practice in 1993. Since that time he has continued his research work and medico-legal work. He has written 4 books and over 200 medical papers, his particular interest being medical history, the treatment of spinal injuries, vascular disease of the spinal cord and sporting accidents causing spinal injuries. As a result of these researches he was responsible for a change in the laws of rugby union following which there was a reduction in serious spinal injuries. He described a new disease, familial spastic paraplegia with amyotrophy of the hands, which is eponymously named after him. He is a Fellow of the College of Physicians of Edinburgh and London, and wrote his M.D. on the history of the treatment of spinal injuries upon which this book is based. He has been Chairman and President of the Tissue Viability Society and President of the Sports Medicine section of the Royal 285 286 About the Author

Society of Medicine, and also council member of the History of Medicine section of the Royal Society of Medicine. He has been a council member of the International Medical Society of Paraplegia and on the editorial board of Paraplegia. He is married to Marilyn who is a psychiatric social worker. He has two sons, one of whom is a dentist, the other is a solicitor. His hobbies are reading, historical research, tennis and swimming. Index

Abderhalden, Emil, 200 Anthropology, 185 Abortions, 194 Antibiotics, 114, 178, 248, 249, 265 Abram Peel Hospital, 33 Anuria, 20, 30, 42, 62 Abramson, Arthur, 126,258 Arias/Margot Fonteyn, 93 Academic standards, 196 Asphyxiation, 212 . Accidentprevention, 174, lSI Associated injuries, 28, 35, 100, 104, 168, Active splints, 234, 256 227,237,248 Activies of Daily Living, 12S, 130, 142 Ataxia, 177, 178 Acute myelitis, 225 Augustana Hospital, Chicago, 112 Acute units, 70-71, 250 Austria, 183,203,256 Addison, Thomas, 45 Universities, 183 Agnes Hunt & Robert Jones Hospital, Autonomic dysreflexia, 20, 42, 83 Oswestry, 70, 71 nervous system, 158,216,225,229,258 Air raid victims, 191 Avicenna,7 Alcohol block, 178, lSI Alexandria, 6 Babinski, Joseph, 30, 178 Allen, Alfred Reginald, 109, 130 Balkan war, 167 Althoff, 199 Bangour Hospital, 70, 71, 73, 74, 76, 77, 79, Ambulation, 81,118,120,121,122,126, 80,83 127,128,150,170,173,235,254 Barcelona, 260 American Medical Association, 131, 132 Barre, J.A., 205, 229-232, 236, 237, 259 Amputation/amputees, 45, 57, 91,129,136, Base hospitals, 251 170, 175,204,206, 218, 238, 255 Basingstoke, see Canadian Neurological Anaemia, 248 Hospital Anaesthesia, Behring, E.A., 198 general, 236, 241 Bell, Charles, II, 14, 110,208,209,219, local,236 221,222,224,242,244,245,246,247, Ancoats Hospital, 60 252 Andry, Nicholas, 208 Bell, John, 15 Animal experiments, 109-110, 130, 154, 162, Bellot, V., 227, 238 167,218,221-224,244 Benes, Vladimir, 183, 243 Anschluss, 183 Bennett, G., 243 287 288 Index

Bergmann, Ernst von, 107 Buchenwald patient, 248 Berlin, 151, 152, 154,263 Buck, Gwen, 72, 80, 98 Bern, 145, 154 Burrell, Herbert Leslie, 101, 110,130 Bernard, Claude, 214, 220, 221, 222 Buzzard, E. Farquhar, 29, 45, 251 Bethnal Green Hospital, 32 Bird, Golding, 45 Cairns, Hugh, 25, 58-59, 62, 65, 70, 86 Birmingham General Hospital, USA, 120, Calcium metabolism, 258 123,124 Calculosis, 126, 150, 160, 163,210,247 Birth defects, 190 California Paralysed Veterans' Association, Bismarck, Otto von, 261 124 Bladder management, 36-38,42,53,64,80, Calipers, 170, 252 100,104, III, 114, 119, 137, 141, 149, Caliper magazine, 136 151, 154, 15~ 163, 171, 172, 17~ 182, Calot, Jean-Fran~ois, 230, 245 230-232,246,247,249,250,257 Cameron, J.E., 127 drug treatment, 231 Camus, Jean, 205, 230, 232, 234-238, 255, mechanics, 217 261 pressure studies, 24, 171, 231 Canada, 125, 135-144,248,254,257,260, rupture of, 35 262 Blaschko, Alfred, 199 Canadian Medical Association, 136, 137 Blind, 136,255 Neurological Hospital, 62,71,138 Blisters, 229 Paraplegic Association, 139 Blood transfusion, 83, 121, 138,248 Carmichael, Edward, 58, 62 Boer war, 19,21,167 Cars, 142 Bohler, Lorenz, 137,181,183,204,245 Cassirer, Richard, 166, 175 Bohlman, H., 61,131 Casualty, Bone graft, 1 1 1 Clearing Hospitals, 67 Bonnin, Josiah, I rates, 20, 21 Borchard, August, 166, 175 Catabolic state, 248 Borchardt, M., 166, 175 Catheterisation, 17,34,37-38,41,76,80, Bors, Ernest, 2, 123, 133,203,242,243,249, 106,158,162,209,216,230,231-233, 261,264,267 241,246,247,257 Boston City Hospital, 2, 99,101, III, 112, Cauda equina lesion, 18,207, 231, 234, 238, 251 253 Botterell, Harry, 125, 135, 137, 138, 139, Cellulitis, 249 140, 142, 143 Central Middlesex Hospital, 265 Bowel management, 54, 138, 141 Cerebral paraplegia, 149 Braces/splints, 121, 126, 129,207,255 Chamberlain, Houston S., 185 Bracken, 262 Chapel Allerton Hospital, Leeds, 71 Breslau, 178, 204 Charcot, Jean Martin, 99, 177, 205, 206, 213, Bright, Richard, 45 214-217,218,220,222,225,229,232, Brighton Hospital, 31 243,244,246,247 Bristow, W. Rowley, 251 Charlatans, 253 Broca, Paul, 221 Cholera, 94, 153 Brodie, Benjamin, 15, 16,247 Christie Street Military Hospital, 140, 142 Brown, M.E., 140 Christopher, Frederick, III Brown-Sequard, Charles Edouard, 99, 205, Circulation, 229 206,213,214,220-226,229,236,243, Civilians, 82, 143 244,246 Cline, Henry, 12, 13 Brussels, 167 Cloward, R.B., 131 Brutalisation, 196 Club feet, 153 Index 289

Coal miners, Accident Hospital for, 85 Diefenbach, Johann, 153 Cobb, Stanley, 112, 113 Director, 147 Coccyx, fracture ot~ 207 Disc, prolapsed, 17 Collegium Medicum, 147 Discharge home, 122, 176,253,254 Collier, James, 29, 34 Dislocations, see fracture management Col over, Jack, 25 Disraeli, Benjamin, 264 Comarr, A. Estin, 124,243 Dolfus, Paul, 239 Committee on Peripheral Nerve Injuries, 25, Doll, Richard, 265 62 Dott, Norman, 25, 58-59, 62, 65, 70, 77 Compensation, 157 Dressings, 229, 230 Concussion of the spine, 109 Duchenne, Guillaume, 18, 152 178, 205, Cone, William, Ill, 138 206,213,214,218-220,225,256,263 Conference Interalliee, 233 Duchess of Gloucester House, 257 Contidentiality, 194, 203 Dunblane War Hospital, 33 Connors, John Fox, III Dunstan HiIl Hospital, Newcastle, 71, 73 Constant attendance allowance, 82 Dupuytren, GuiIlaume, 205, 210-213, 214, Consultants, 77, 78, 121, 176, 232, 252, 264 226,232,243,244,250 Contemporary accounts, 94-98 Contractures, 16,53,91,101,156,170,219, Early admission, 249, 250, 267 246,250 East Preston Military Hospital, 33 Cooper, Astley, 11, 224, 244 Edinger, Ludwig, 23,154 Cordotomy, 121, 178, 181 Editors' Law, 195 Corticosteroids, 109, 113 Egham, 255, 256 Counsell, John, 139, 143 Egypt, 5 County Council Hospitals, 66, 265 Ehrlich, Paul, 203, 264, 266 Craiglockart Hospital, Edinburgh, 33 Eiselberg, v., Freih, 146, 166, 167 Crimean war, 18 Electricity, 43-46, 49-50,53,91,106,151, Critchley, Macdonald, 23 152,218,225,234,251,253,256 Crutchfield, W.G., III Elsberg, Charles, 106, 109, 130 Curling, Thomas Blizard, 16 Emergency Medical Services, 68, 69, 73, 74 Cushing General Hospital, 120 Empire Hospital, 25, 27, 31,32,36,40,46, Cushing, Harvey, 21,23,24,30,32,38,39, 103,251 41, 58-60, 62, 65, 86, 90, 94, 102, 103, Enabling Laws, 202 107,112,130,151,155,158,226,233, Enbrook House, 47 244 Enderlen, Dr., 166 Cystotomy, 38, 42, 78,121,138,140,172, Epilepsy, 238 247,257 Equipment, 50, 54, 77, 80, 82,138,161,170, Czechoslovakia, 264 171,230,231,234,236,251,252,255 Erb, Wilhelm Heinrich, 145, 147, 150 Dalechamps of Lyons, 208 Erysipelas, 173 Deaver, George, 128, 140,254 Euclid Hall, 136 Debridement, 236, 244, 249 Eugenics, 183-184, 186, 189, 199-200 Dejerine, Joseph, 178 Euthanasia, 146, 183, 186-191 Dejerine-Klumpke, Auguste Mme., 205, 227, Ewell War Hospital, 33 232,234,237,238,258,261 Examination, 17, 101, 109-110, 155, 156, Denny-Brown, Derek, 58, 62, 113,258 16~ 169,213,218,220 Diagnosis, 176 Examinations, Higher, 196 Diaphragm, 164, 218 Executions, 195 Dick, Thomas, 55, 65, 72, 73, 80, 84, 94 Exercises, 209 Dickie, Ronald, 48 Experiments, 290 Index

brain & tissue research, 20 I Fraser, Forbes, 38 cholera, 200 Frazier, Charles Harrison, lOS, 106,107, high altitude, 200 108,112,130,131, 151,245,253,259, presentation of, 20 I 263 surgical, 20 I Freiburg, 160 survival at sea, 200 Frenkel, Heinrich,43, 91,153,177-178,181, wound,200 225,256 Extermination camps, 187 Fresson, Monsieur, 234 External sphincter, 171 Freud, Sigmund, 202 Friedreich, Nikolaus, 150, lSI Fabricius ab Aquapendente, 9 Functional electrical stimulation, 219-220 F achschaften, 196 F agge, Charles Hilton, 16 Galen, 6, 7 Female patients, 143 Galen, Archbishop, 190 Ferguson, Dr, 94 Galton, Francis, 184 Fertility, 194 Garches Hospital 239 File, health, 194 Gask, George, 94 Financial arrangements, 27,117,118,125, Gaza, Dr., 166 132,143,251,257,267 General Hospital No II, New Jersey, 105 First World War, 20-56,65,80,84,94,99, General hospitals, 180 103,145,166,181,183,187,204,206, General Hospitals, France, 30, 35, 60 226,227,238,243,244,246,247,252, General Practice, 197 253,254-259,260,262,267 General Practitioners, 180, 183, 193,203 Fischer, Eugen, 184 General Surgeon, 249, 265 Fistula, 163 Genetic Health Courts, 189 Foerster, Otfrid, 83, 85, 91,107,112,146, Genetic illnesses, 189 147, ISS, 169, 174, 177, 178-181,213, George Speyer-Haus, 266 220,256,263,264,267 Gennan Foster-Kennedy, Robert, 23, 30 academic unit, 265 Fox, Fortescue, 236 Neurological Association, 85, 194 Fractures, universities, 197 definitions of, 244 Germany, 145-204,219,227,230,239,248, management of, 6,12,19,58,59,61,63, 256,258,259,260,261,263 64,102,105,106,107,108,137,150, curriculum changes, 197 156,157,161,162,165,181,207,209, social problems, 197 211,212,224,236,241,244,245 Gillies, Harold, 57 mechanics of injury, 60-61, 108 Gingras, Gustave, 138 surgical treatment of, 108, 116, 120, 130, Girdlestone, Gathorne, 77 132, 158, 160, 162, 173, 174, 175, 176, Glen Lomond War Hospital, 33 210,213,241,244,245 Glisson sling, 181 traction, 131, 156, 160, 161, 162, 182, Gobineau, Joseph, 185 209,245 Goddard, Mrs E, 73, 79,83 cervical, III Goodwin, General, 31 halter, III Graham, James, 45 France, 147, 183, 184,204,205-240,250, Grands Mutiles, 256 251,252,253,255,256,258,259,260, Greece, 5, 6 261,262 Greenfield, Joseph, 62 College de, 220 Gregg, Alan, 112 Frank, Johann, 148 Grossiord, A., 239 Frankel, Hans, 2, 3, 243, 253 Index 291

Guillain, George, 205, 229-232, 236, 237, Holistic approach, 197 259 Holmes, Gordon, 23, 30, 32, 34-36, 38, 40- Gull, William Withey, 16 42,55,57,62,65, 154,251,257 Gunshot wounds, 107, 138, 167,235 Horder, Thomas, Lord, 177 Guttmann, Ludwig, 1,3,70,72,77,78,80, Horsley, Victor, 16, 23, 58, 155 83,84,85-98,107,112,117,125,140, Hospitals, building of, 194 144,146,160,169,179,181,185,203, Hotel Dieu, 206, 210 206,227,239,242,243,245-247,250, Hottentots, 184 254,256,258-267 Hulke, John Whitaker, 18, 20 personality, 266-267 Hunter, John, II principles/methods of treatment, 87-89 Hurstwood Park Hospital, Haywards Heath, Guy's Hospital, 45, 115 70,71 Gymnasium, 46 Hutchinson, Jonathan, 16, 17 Hutted Hospitals, 67 Haber, Fritz, 203 Hydrotherapy, 43, 46,121,150,151,153, Hackwood Park Hospital, 62 164,235,253 Haematomyelia, 77, 217 Hyperbaric oxygen, 109 Hales, Stephen, 210 Hyperpyrexia, 19,20 Hall, Marshall, 18,45, 148, 221 Hypothermia, 28, 30, 35, 39, 42, 62 Hammond Army Hospital, 123, 124 Hysteria, 148 Hanging, 212 war, 191 Hardy, Alan, 250 Harris, Phillip, 73 Immobilisation, 160, 161,225 Harris, Robert Inkerman, 137 Incontinence, 223, 229,230, 231 Harris, Wilfred, 45 Institute for the Crippled and Disabled, Harvard, 112, 220 Bellevue Hospital, 128 Harvey, William, 8 Institute of Rehabilitation Medicine, 126 Head, Henry, 16, 23, 24, 32, 36, 40, 42, 55, Institutionalisation, 51, 55 57, 58, 65, 84, 155, 172, 213, 220, 251, Intrathecal alcohol block, 121 257,258 Invalides Hospital, 232,234,237 Healers, lay, 183 natural, 195 Jackson, John Hughlings, 99, 178 Heidegger, Martin, 195 Jackson Burrows, Harold, 2, 254 Heidelberg, 150, 178 Jefferson, Geoffrey, 59, 60, 62, 64, 70, 72, Heiden, 177 110,137,138,245 Heisenberg, Werner, 192 Jews, 6, 85,152,154,165,179,185,191- Hemiplegia, 47, 178 197,199,202-204,261,263,264 Henle, Jacob, 147,202 Jinisek, A., 183 Hereditary, 185 Johnson, Lyndon, 132 Herpes, 155 Jones, Robert, 43, 69, 95 Heterotopic ossification, 126,205,232,237, disabled workshops, 254 238,258 Jousse, AI, 135, 139, 140, 142,254 Heydrich, Reinhard, 201 Jumentie, MJ., 227 Hindu medicine, 7 Junior doctors, 264 Hippocrates, 5, 244 Hippocratic apparatus, 206 Kaiser-Willhelm Institute, 199, 200, 203, 262 Hitler, Adolf, 66,183,185-187,189-190, Kennedy administration, 132 195,204 Kennedy General Hospital, 120 Hobson, Elvira, 81, 129 Kennedy, R.H., 122, 233 Holdsworth, Frank, 2, 77,245,249,250,254 Keppler, Wilhelm, 166, 175 292 Index

Kerr, Alan Sutcliffe, 72, 77 Liverpool, I, 66, 72 Kessler, Henry, 126 Llandrindod Wells Hospital, 71 Kilner, Thomas, 57, 76 Lobenhoffer, Dr., 166 King George V Hospital, 26, 27, 31, 32, 34, Local Authority, 82 36,37 Hospitals, 67 King's Lancashire Military Convalescent Lodge Moor, see Sheffield Spinal Unit Hospital, 33,46 Loewi, Otto, 196 Kleist, Dr., 166, 175 London, II Knight, Geoffrey, 64 London General Hospital, Denmark Hill, 32 Kocher, Theodor, 145, 146, 147, 151, 154- London Hospital, The Royal, 16,24,25,27, 158,176,181,247 31,32,46,59,63,65,95,251,265 Konigsberger Hospital, 170 Long Beach Hospital, 124,261,267 Konigshiitte, 85,159,160,165 Longet, M., 222 Kraepelin, Emil, 178 Lonsdale House, 32, 46, 57-58 Krankenbehandler, 85, 204 Lorenz, Adolf, 189 Kratzenstein, Gottlieb, 45 Louis, Antoine, 210, 212 Krause, Fedor, 166, 175 Lucas-Championniere, Just Marie, 44 Kronecker, Hugo, 155, 158 Ludloff, Dr., 166 Krueger, E.G., 243 Ludwig, Carl, 147 Kriiger, Dr., 166, 175 Lumbar puncture, 164 Kriikenberg, H., 166, 175 Lyme Green, 257 Kunc, Z., 183 Lyndhurst Lodge, 135, 139, 140, 141, 142, Kyphosis, 160 143 Kyphus,156 Kytes Estate, 254, 257 Maceration, 216, 229, 230 Macewan, William, 58, 155, 167 Laminectomy, 6, 8, 12, 13, 15, 26, 38, 61, Magendie, Fran90is, 209, 214, 218, 221, 243 63,100, \09, 116, 131, 168, 169, 170, Maida Vale Hospital, 25, 31, 33 206,224,236,244,245,258,263 Makins, George Henry, 19 Lanfranc of Milan, 8 Malfonnations,190 Le Gros Clark, Professor, 210 Manchester Royal Infirmary, 60 Leadership, 89 Manipulation, 162,213 Leatherhead Hospital, 55,71, 81 Mansfield General Hospital, 94 Leipzig, 196 Manual reduction, 245 Lenz, Fritz, 186 Marburg,Otto, 146, 166, 167-175,176,183, Leonardo da Vinci, 8 203 Leri, A., 30 Marie, Pierre, 30, 205, 226, 229, 230, 231, Lewis, A.1., 62 233,238,246 Leyden, Ernst von, 43 Markham, J.W., 243 Lhermitte, Jean, 205, 227, 229, 230-233, Martin-Magron, Dr., 220 236,238 Massachusetts General Hospital, 112 Liepmann, 172 Mass reflex, 42, 94 Life expectancy, 13, 18, 19,34,35,48,61, Massage, 40, 42, 43, 44, 49-50, 54, 80, 81, 83,95,101,105, \08, 109, 110, 116, 118, 100, 170, 225, 234, 251, 253 120,150,157,164,168,173,174,2\0, school, 246 237,238,245,259,262 Masseuses, 100 "Life unworthy oflife", 188, 189 Almeric Paget Massage Corps, 44, 49, 50 Limburg, Bishop of, 190 Incorporated Society of Trained Ling, Pehr, 43 Masseuses, 43, 44 Lithotomy, 210 Maudsley Neurological Clearing Hospital, 33 Index 293

Maury, Marc, 239 Muscular action, 219 McAlpine, Robert, 64, 84 prostheses, 218-219 McCaw Hospital, 120 Myerson, Abraham, 112 McGuire General Hospital, 120 Mcindoe, Archibald, 51 Nathan, Peter, 25, 64 McKenzie, Kenneth.G., Ill, 136-137, 142 National Health Service, 262, 267 McKibbin, Brian, 95 National Hospital for Nervous Diseases, see Mechanistic medicine, 197 Queen Square Medford Ambulation Centre, 118 National Spinal Injuries Centre, see Stoke Medical Research Council monograph, 42, Mandeville Hospital 50,64,245,251,252 Nazi, 146, 174, 177, 179, 183-185, 188-189, Medicochirurgicum, 147 191-199,202-203,256,261,264 Medicolegal implications, 212 art, 192 Mein Kampf, 187 censorship, 192 Mengele, J., 199-200 doctrine, 199, 204 Meningitis, 35, 238 doctors, 192, 193 Mennell, James, 44 experimentation, 198,200-201 Mental Hospitals, 67,187,188,190,191 morality, 198 Mentally subnormal, 184, 189,261 Neisser, A., 198, 199 Mercogliana, A., 224 Neosalvarsan, 172, 175, 176 Merle d'Aubigne, 239 Nerve function, 148 Middlesex Hospital, I, II, 18,45,64,74,81, grafting, 176 246,265 Netherlands, 194 Military hospitals, 180, 181 Netley Hospital, 32, 34, 36, 46 Miners, 79, 85, 95, 165 Neuritis, ascending, 152 Miners' Rehabilitation Committee, 95 Neurological Institute, 167, 174 Ministry of Health, 93, 96 Neurologist, 80 of Pensions, 28, 82, 84, 180, 252, 262 Neurology, 99 of Pensions Hospitals, 66, 67, 74 Neuroradiology, 107 Mishandling/dangers of movement, 156, 161, Neurosurgeons, 245, 246 211 Neurosurgery, 58, 102, 104 Missed injury, 15 Neurosurgical residents, 245 Mitchell, John Kears1ey, 101 Newcastle, see Dunstan Hill Mobilisation, 40 Newton D Baker Hospital, 120, 122, 127 Montreal Neurological Centre, 139 Nicoll, E.A., 83, 94, 95, 135, 143,245,254 Morphine addiction, 53 Nobel Prize, 145, 155, 158, 200, 203 Morrell, Theo, 189, 190, 195 Nollet, Abbe, 45 Mortality, see Life Expectancy Nordic, 185, 186 Moslem medicine, 7 Nuffield Department of Neurosurgery, Mothers' Crosses, 189 Oxford, 86 Mowlem, Arthur, 57 Nuffield Hospital, Oxford, 95 Milller, Johannes, 147, 148, 152 Nuremberg Laws, 85,189 Multiple sclerosis, 47, 64, 259 Nursing care, 13, 19,41,49,53,78,106, Munro doctrine, 113, 117, 141 120,137,160,170,229,233 Munro, Donald, 2, 64, 99,111-119,123,125, staff, 106, 230, 232, 251, 265 133,135,140,141,142,143,242,243, Nutrition, 248 245-249,251-254,257,259,261-263, 266,267 Obersteiner, Heinrich, 174 Lecture, 243 Occupational therapy, 77, 80, 81,181 Muscle biopsy, 219 Oftlcers' Hospital, Ireland, 33 294 Index

Ohry, A., 243 Plaster beds, 61, 62, 64, 65, 77, 79, 182, 246 Olympic stadiums, 260 casts, 119, 126, 160, 230 One doctor in charge, 230, 238, 252, 263, fixation, 110 265 jackets, 182 Oppenheim, Hermann, 99,145,147,154, Plastic surgery, 27, 57, 76 165, 167, 202, 264 Platt, Harry, 60 Orderlies, 7S Poland, 190, 202 Orthopaedic institutes, 153 Poliomyelitis, 77, 139, 219 surgeons, 77, SO Polyuria, 20, 10 1 Osler, William, 102 Porritt, Arthur, 265 Osteoporosis, 126 Posen, 190 Oswestry, see Agnes Hunt & Robert Jones Post mortem, 212, 213, 214 Orthopaedic Hospital Posterior nerve root section, 178, 181 Outsider, 263-264 Postural reduction, 262 Oxford, 181, 258, 263 Potbelly, 219 Pott, Percival, 208 Pagel, Julius, 199 Prague, 147, 183 Pain, 53,157 Pre-Renaissance, 8 referred, 155 Pressure sores, including prevention, 17,35, behaviour, 148 40,41,47-55,79,84,100,101,115,141, Palatal paralysis, 164 149,151,154,157,160-161,162,169, Paralytic ileus, 16, 19,20,175 171, 176,209,210,213,215-217,222- Paraplegic Games for the Disabled, 252 225,228-231,241,246,248,249,259, Pare, Ambroise, 8, 149,205,206-207,209, 265 217,244 distribution of, 215 Paris,218,220,242,264 surgical treatment ot~ 79, 80, 115, 121, Park Prewett Hospital, 93 138,230 Parkinson, James, 16 Private practice, 265 Pathology, 14, 17,35,38, 150, 158,160, Prognosis, see Life Expectancy 163,168,174,211,212,213,217,225, Prvssia, 146, 147 236 Psychiatric pensioners, 34 Pathophysiology, 152 Psychiatrists, 34, 188-190 Paul of Aegina, 6, 8, 244 Psychological effects, 41,89,94,96,118, Payr, Dr., 166 125,138,140,161,170,209,237,266 Pennybacker, Joseph, 65, 77 Psychologist, 80, 127 Peripheral nerve injury, 180, 181 Psychology, 84,121,122,128 Peripheral nerve injury units, 178, 179,256 Public Record Office, 66, 73 Perthes, George, 166 Pyelonephritis, see Renal Failure Peter Bent Brigham Hospital, 112 Petit, Jean Louis, 205, 20S-209, 229, 244, Queen Elizabeth's Training College, 81 246 Queen Mary, 47 Pfannmuller, 190 Queen Mary's Hospital, Roehampton, 27, 31, PH of urine, ISO 256 Phantom limbs, 225 Queen Square, 23, 25, 31,32,33,46,57-59, Phrenic nerves, 21 1 62,65,70, ll2, ll3, 220, 251, 262 Physically handicapped, 261 Physiotherapy, 43, 50, 77, 80, SI, 91, 96, Racial hygiene, 184, 193, 197 116,127,153,170,176,178,181,249, Racial Science Institutes, 185 252,253,254,256,263 Racism, 183-185,192 Planck, Max, 187 Railway spine, 109 Index 295

Ranzi, Egon, 166, 167, 170, 174 Rowbotham, George frederick, 25, 65 Rascher, Sigmund, 200 Royal Air Force, 1,65,66,95 Recollections, 98 Royal Canadian Army Medical Corps, 138, Recreation, 48, 51, 55, 83, 141,235,238, 140 257 Royal family, 93 Red Cross, 82 Royal Infirmary, Sheffield, 79 Auxiliary Hospital, 44 Royal National Orthopaedic Hospital, Military Hospital, Liverpool, 33 Stanmore, 1,70,71,95 Reduction, dangers of, 211 Royal Society of Medicine, 86 Reeve, Christopher, 93 Royal Star & Garter, 26, 27, 31, 32, 34, 36, Rehabilitation, 42, 43-46, 48, 51, 80, 91, 118, 37,46,47-55,57-58,71,81,83,91,239, 119, 126, 128, 179-180, 182, 188,204, 251,252,253,255,259,260,262 236,238,241,246,250,251,252,253, Rusk, Howard, 126 254,256, Russian-Japanese war, 167 doctor, 126 Remak, Robert, 148, 151, 152, 154, 202, 264 SI Bartholomew's Hospital, 94 Remedial gymnasts, 81 St Joseph's Hospital, 137 Remploy,81 St Thomas's Hospital, 32 Renaissance, 8 Salerno,8 Renal failure, 14, 18,35,36,37,54,101, Salford Royal Hospital, 60 107,115,163,172,227,231,247 Salmon, T.W., 30 investigations, 121 Salpetriere Hospital, 214, 218, 234, 237 stones, see Calculosis Sargent, Percy, 23, 29, 30, 38, 41, 251 Reparations, 188 Sauerbruch, ferdinand, 200 Research, 42, 58, 83, 86, 90, 257-258, 264 Savile, Jimmy, 93 Residual urine, 171 Scandinavia, 126 Respiratory complications, 160, 164, 238, Schizophrenics, 189 249 Schlatter, Carl, 166 failure, 225 Schneider, Richard, 131 Rhizotomy, 116, 121,258 Schiinlcim, Johann, 152 Riches, Eric, 78,247,249 Schumm, 172 Richond, M., 212 Schwartz, Oswald, 146, 167, 171, 172,203 Riddoch, George, 16,23,25,32,36,40,42, Scoliosis, 207, 208,210 55,56-59,62,65,70,78,83,84,86,93, Scruton, Joan, 2, 72, 98, 254 94,172,251,257,258 Seale Hayne Hospital, 33 Riehl, Prof., 171 Second World War, 2, 63-64, 66-69, 119, Roaf, Robert, 95 245,248,253,254,256-259,262,267 Robertson, E. Graeme, 58, 62, 258 hospital provision for casualties, 67-69 Rockefeller Foundation, 112,113,132,178, Seddon, Herbert, 71, 77, 93, 95 262,263 Sepsis, 40,79,84,100,160,163,209,216, Roland of Parma, 8 229,231,245,247,248,249 Romans, 6, 46 Service women, 77, 79, 82 Romberg, Moritz H., 145, 147,148-150,151, Sexual activity, 118, 140 202 Sheffield Intlnnary, 250 Ronkswood Hospital, Worcester, 71 Sheffield Spinal Unit (Lodge Moor), 2, 76, Rookwood Hospital, Cardiff, 57, 71 79,96,143,249 Roosevelt, Franklin, 132, 139, 142,252 Shell shock, 32, 65,191,238 Rossier, Alain, 125, 239 Sheppard-Towner Act, 131 Roussy, Gustave, 205, 227, 229, 230-233, Sherren, James, 17,59 236,238 Sherrington, Charles, 178 296 Index

Sitting aids, 234 Statistics, 21, 22, 34, 35, 37, 48,56-57,61, Skin grafts, 79 63,71,83,99-100, 104, 105, 106, 116, Slogett, Lady, 51 118,120,121,130,131,138,141,156, Smith, Edwin, 5 166,209,237,245,250,253,258,259 Social implications, 172 Steinthal, Dr., 166 integration, 172 Stepping retlex, 42 Social Security, 146, 181,262 Sterilisation, 184, 189, 191, 193-194 Societe de Biologie, 221 Steroids, see Corticosteroids Sorbo mattress, 79 Stevenson, W.F., 20 South, John Flint, 15 Stoke Mandeville Hospital (N.S.I.e.), 1,2, Southern General Hospital, Birmingham, 33 66,71-75,76,77,78,79,80,81,83,84, Southern General Hospital, Plymouth, 33 86,92,93,94,95,96,138,143,144,181, Spasms, 156, 162, 182 239,245,247,250,252,254,256-260, Spastic paralysis, 190 263 Spasticity, 170, 171 Stolper, P., 145, 154, 160,243 Special Hospital for Officers, Palace Green, Stookey, Byron Polk, III 33 Stromeyer, George, 153 Specialisation, 21, 23, 41, 60, 94, 112, 146, Striimpell, Adolf; 145, 150-151 197 Sunlight, 230 Specialised hospitals, 27, 69 Surgical shock, 248 units, 84, 168, 171, 172, 174, 176,230, Sweating, 83, 86, 91, 94, 158, 168-169, 176, 233,234,238 181 Spinal cord, Sweden, 184 blood supply to, 225 Swedish drill, 43 dermatomes, 213 Swimming, 42, 46 infarction of, 13,77 Sydney, 260 localisation, 26 Sykes, Dr, 94 management of injury to the, 36, 38-39, Symonds, Charles, 62 40,167,169 Symonds, Charters James, 20, 25, 34, 36, 39, shock, 42, 45, 221, 233, 236 41,46,244 surgical treatment of, 173, 174, 224, 236, Symptoms, acute onset, 149, 150, 165 263 gradual onset, 149, 150,217 Spinal, surgeon, 246 Syringomyelia, !OI, 107, 160, 163,209,211, units, I, 2, 69-84, 249, 251, 252, 262, 267 238 Spine, angulation of, 250 anatomy of, 211 Tabes dorsalis, 177, 178,256 stability of, 95, 245 Tebbit, Mrs, 93 Sport, 45, 51,91, 128, 142,260 Tendon transplants, 40, 42 equipment, 260 Territorial Force General Hospitals, 44 Sports injuries, 174 Tetanus, 100 Springfield War Hospital, 33 Thom, Douglas, 122 SS, 194, 196, 199 Thomas, Hugh Owen, 43 Staff, Thomson Walker, John William, 26, 29, 34, supervision of, 230, 233,246 36,37,38,40,55,57,58,259 training, 247, 258 Thorburn, William, 16,26,34,35,37,39, Stafting,48,49, 120-121, 179, 197,252 40,42,60 Standing, 81 Thorndyke, Paul, 112 frame, 40 Tidal drainage, 64,80,114,118,119,121, Stanley, Lord, 264 137,141,247,254 State medicine, 28 Tilmann, Dr., 166 Index 297

Tissot, Joseph-Clement, 209-210, 246 Volk, 183-184, 188, 193, 197 Tooting Hospital, 31, 46 Voluntary Hospitals, 66, 67 Toronto General Hospital, 137 Vulpian, Dr. E.F.A., 221 Training, 116, 118 of staff, 116, 122, 142 Wagner, Wilhelm, 85, 107, 108-110, 145, Transfer of patient, 79, 119,231,238,249, 146,154,158,159-164,176,181,182, 252 226,241,243,244,246,247,248,249, Transport, 20, 21, 28,32, 35,39,42, 64, 104, 250,252,257,258,261,263,266,267 105,120,160,175,230,233,247 Warburg, Otto Heinrich, 203 Transverse myelitis, 77 Wassermann, August von, 199 Tremblay Mary, 135, 136 Water baths, 161 Treves, Frederick, 25, 32, 47 beds, 17, 110, 150, 157, 166, 17l,234 Trophic nerves, 216, 229 cushion, 160 Trotter, Wilfred, 251 Watson-Jones, Reginald, 59, 62-64, 95, 96, Tuberculosis, 77, 173,208,217,246 110, 143, 245, 249 Tumours, 77 Webb-Johnson, Alfred Edward, 21, 34, 35, Turning, 90, 96,115,121,138,161,209, 36,37,41,55 215,230,246,249 Weir Mitchell, Silas, 43,100,107 Tyrell, FredL'lick, 12 Weizsacker, V. von, 204 W clbeck Street, 33 United Kingdom, 11-84, 183, 184,204,206, Welsh Hospital, 32, 34 239,245,246,248,249,252,254,255, Wenzel Hancke Hospital, 179, 203 256,257,258,259,260,261,262,264 Wernicke, Carl, 178, 179,219 United States, 80, 95,99-134,142,143,184, West Roxborough, 125 220,239,242,245,248,251,253,254, Western General Hospital, Stockport, 33 256,259,260,261,262 Westminster, 32 University College Hospital, II Wharncliffe Hospital, Sheffield, 71, 73, 76, University hospitals, 265 77,79, 81,83,250 Urologists, 26, 78, 80, 118 Wheelchairs, manual, 42, 54, 77, 82, 139, 234,252,253,260 Vaccination, 172 motorised, 51, 82 Vasomotor function, 222 Whitteridge, D., 258 nerves, 157 Wilson, Samuel Kinnier, 58 Vaughan General Hospital, 120 Wingfield Morris Hospital, Oxford, 71 Vellacott, Phillip, 21, 26, 34, 35, 36, 37, 40, Winner, Dr. A., 93, 95 41,55 Winwick Hospital, 62, 70-74, 76, 77, 78, 79, Venous thrombosis, 40 80,81,83,84,94 Ventilators, 257 Women, 262 Vesalius, 8 Women of the Empire, 262 Veterans' Administration, 120 Woodhall, Barnes, 119-120 Hospitals, 1,2,116,123,125,132,133, Wright, Samson, 220 254,260,262,264 Wynne-Jones, 135 Vienna, 147, 148, 167, 174, 181, 192 Virchow, Rudolph, 107, 145, 147, 148, 151, X rays, 39,48,116,155,162,163,166,169, 152,155 173,200,209,230,245 Vocational training, 51, 81,119,122,127, 128,236,256