Who was Lewis A. Sayre?
Lewis A. Sayre (1820-1900), was a surgeon of significant renown and an important figure in the history of orthopedics in America. He was a charter member of several medical societies, including the American Medical Association, and served as its president in 1880. Among the procedures that he pioneered in his private practice was a process during which the patient was suspended, hanging by the arms, in order to stretch the spine and relieve stresses caused by an irregular curvature, while a plaster of Paris “jacket” was fitted in order to hold the spine in place after suspension. In Spinal disease and spinal curvature (1877), Sayre details his experiments treating scoliosis and Pott’s disease (spinal tuberculosis) with the plaster jacket. He also includes an extensive series of clinical comparisons between his jacket and the more expensive and cumbersome iron braces that were in use at the time. The case studies, which describe a range of successful outcomes, are richly illustrated with drawings and photographs like the ones above.
Treating Scoliosis
Recalling his first use of suspension before the application of the jacket, by which he intended to accomplish nothing more than a temporary alleviation of symptoms until a commercially-available brace could be acquired, Sayre writes:
“In November 1874 a little boy, four years of age, was brought to me having a sharp posterior curvature of the three last dorsal and the first lumbar vertebrae, together with partial paralysis of the rectum and one leg … I directed one of my assistants to suspend the boy by the arms, in order to see what effect would be produced; and I noticed that, as soon as the body was made pendent, there was more motion in the paralysed limb than before, that the pain was very much relieved, and that the patient was breathing with greater ease. While he was suspended in this manner, I pulled down his shirt and tied it between his legs, thus making it fit the body closely and smoothly; and then, commencing at the pelvis, I applied rollers saturated with plaster of Paris around the entire trunk. At first I was anxious concerning the effect that would be produced on the respiration, but inasmuch as the boy cried lustily, all my fears in that respect were quickly dispelled: so I went on, reversing the bandage, bringing it back to the pelvis, again carrying it upwards, until the body was completely encircled by four or five thicknesses of the roller. The child was then laid with his face downwards on a sofa, and was instructed to remain there until the plaster had become firmly set. When I returned shortly afterwards, I found, to my surprise, that the little fellow had got up from the sofa and walked across the room to a window … When this dressing had been completed, I requested the parents to bring back the child after an interval of ten days, when I proposed to apply and adjust a Taylor’s brace. The above-described plaster jacket had been put on simply for the purpose of rendering the child comfortable whilst being carried home. I did not see either the child or its parents until the following February.”
This book is just one of over 70 titles dealing with spinal diseases and abnormalities, from the 18th- through 20th-centuries, that have already been added to the Medical Heritage Library, including one of Pott’s original works on spinal tuberculosis.
This news post was originally published on the Center for the History of Medicine’s Wordpress site.