William wagnerBiblio.com
Wagner, Wilhelm & Stolper, PaulBiblio.com
Die Verletzungen der Wirbelsäule und des Rückenmarks.
1898209161898. Dtsch. Chir. Lfg.40 . - Stuttgart Verlag von Ferdinand Enke 1898 8° XXXII 564 pp. 232 Abbildungen Leinenband d.Zt.; ExLibris von "Dr. Werner Block". First Edition of "the first successful account of the management of spinal injuries was by Wilhelm Wagner 1848-1900 a general surgeon working alone in a small workers compensation hospital Königshütte Hospital in Upper Silesia where he spent his whole career. He developed the practical treatment of spinal injuries and demonstrated how patients could and should be treated. He wrote a book with his former pupil Paul Stolper 1865-1906 on injuries of the spine and spinal cord. This dealt with every aspect of the subject. He started with anatomy of the spinal column pathology of injury the mechanism of injury the symptomatology and practical treatment including the indications for surgery. He understood the necessity of relieving pressure in preventing pressure sores and was concerned to prevent subsequent deformity. He identified six major problems: sepsis from pressure sores; treatment of cervical fractures; post-traumatic syringomyelia; infection of the chest; stones in the kidneys leading to sepsis of the renal tract; and the necessity of immobilising patients in bed until the fracture healed. The textbook is remarkable in its breadth of vision and its emphasis upon such commonplace but vital aspects of treatment as how the patient should be transported and nursed. Particular attention was paid to the pressure points and positioning of the patient. Water beds were used. He emphasised the need to prevent soiling of the mattress in incontinent patients. For doubly incontinent patients special beds were designed such as those used for cholera patients with a bucket underneath that could be removed. Once the fracture had healed the patient was mobilised and put into a bath. The object of treatment of the spine was to establish bony union. Wagner was opposed to operative treatment on the spine and recommended that radiographs should be used to estimate the position of the fracture. He recommended palpation of the kyphus to reduce a dislocation. He described in detail how a dislocated cervical spine could be reduced. He devoted pages to the description of how the bladder should be managed. Wagner treated patients with spinal injuries and was able to mobilise them. He gave opinions in court about their life expectancy so they were probably returning home. It is remarkable that he carried out all this work alone in a municipal hospital without an academic position." - J.R. Silver History of the treatment of spinal injuries. Postgraduate Medical Journal 81 2005: pp.108-114 unknown
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