Ancient Views of SCI
The idea of a cure for spinal cord injury is relatively new, but even the ancients grappled with spinal cord injury care.
By Tiffiny Carlson
The ancients were not completely ignorant or unaware of the realm of spinal cord injury (SCI) medicine. Thanks to the survival of a number of historical texts, we can peek into the minds of doctors from thousands of years ago, and see their thoughts, opinions, and preferences of treatment (if any) for those unfortunates who sustained an SCI back then, before the advent of antibiotics, rubber or plastic (for the creation of catheters, vents, wheels, etc.), proper seating methods, and even wheelchairs.
One of the first historical records referencing SCI comes from an ancient Egyptian papyrus scroll, dating from 1700 B.C., where it described two incidents of patients having sustained a fracture or dislocation on the neck vertebrae, which was unfortunately combined with paralysis. The scroll declared in each case that they had sustained a condition which was “not to be treated.” There is also a famous Egyptian painting depicting a female lioness injured in battle, dragging her hind legs behind her. This painting gives further proof that the Egyptians were aware of SCI and its devastating results.
Hippocrates and SCI
Fast-forward to the time of the ancient Greeks, approximately 460 – 377 B.C., and things were generally still the same in the ways physicians viewed SCI. Famous Greek physician, Hippocrates, declared that there were unfortunately no treatment options for people who injured their spinal cords “with paralysis in conjuncture,” and were therefore “destined to die,” he wrote in one of his surviving texts. However, for those with vertebrae fractures who had no paralysis, Hippocrates did devise a traction treatment- rudimentary as it was-to stabilize the bones for healing, which is still used to this day, amazingly enough. Now dubbed “The Hippocrates Ladder,” this form of traction was most likely the first medical treatment ever invented to help people with vertebrae fractures to actually heal and live a normal life afterwards.
We must remember that Hippocrates was working in a time where the invention of X-Ray machine had yet to occur, which we all now know is essential in modern day medicine to determine the exact location of the fracture- the first step taken in the first few hours following a SCI. Without knowing the exact location in the section of spinal column where the fracture was, it must have been difficult for Hippocrates or any other physician of the time, or prior, to deal with such limiting medical technologies. But they did use what they had to their fullest advantage. Hippocrates’ “Ladder,” was one such example. It worked by requiring the patient to be bound, tied to rings upside-down, and then “shaken vigorously” to prevent spinal curvature during the healing process. (Sounds enticing!)
Another healing method for fractures that Hippocrates invented was the “Hippocratic Board,” which allowed doctors to apply traction to the immobilized patient’s back, using either their hands or feet on a wheel and axle arrangement.
Discovery of the CNS
It wasn’t until around the time of 200 A.D., however, that the discovery (i.e., the general idea at least) of what the central nervous system was, was discovered by the Roman physician Galen. He proposed that the spinal cord was an extension of the brain and carried sensations to the limbs and back-a monumental discovery. And by the 7th century A.D., Paulus of Aegina, another famous Roman physician, began to recommend surgery for spinal column fractures by removing the bones fragments, which he was convinced was the direct cause of paralysis.
It wasn’t until the Renaissance era (1543), however, that the entirety of the spinal cord, was discovered by physician and teacher Vesalius. He published illustrations of his discovery based on a detailed dissection of the spinal cord. His illustrations allowed physicians to finally be able to fully understand the spinal cord, and more importantly, understand how each section reacts to injury.
Evolving Prognosis
Unfortunately, survival rates for those with SCI (except for the extremely low injuries where bladder and bowel abilities were still intact), were rarely past a year. Infections from bed sores (due to improper seating) to bladder and a variety of other infections, were the usual cause of death. Even up until WWI, 90% of soldiers who sustained an SCI in battle died within the year.
WWII and its injured soldiers, however, were the “sun” so to speak. The war produced thousands of soldiers with SCI, and many were surviving, proving that sustained life post-injury was possible. This of course is thanks to the invention of antibiotics, the X-Ray, and proper seating for wheelchairs.
Since the 1940s, things have only gotten better for people with SCI. We should consider ourselves lucky to live in a time where SCI is understood and healed,fracturewise. With the proper care and diet, our lifespans are relatively equal to our nondisabled counterparts.
Now that is, historically and statistically speaking, amazing.
Tiffiny Carlson is a frequent contributor to Action.
