The Mythical Bill: A Neurological Memoir

Appendix: A Brief History of Surgical Approaches to Torticollis

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Appendix A Brief History of Surgical Approaches to Torticollis Second century a.d.: Antyllus, a Greek surgeon, practices tenotomy, the cutting or dividing of a tendon. Medieval era: Itinerant practitioners—charlatans, quacks, and mountebanks — perform tenotomy, cymbals clanging to drown out cries of patients. Fabricius of Padua (1537–1619): Anatomist, surgeon, and tutor of William Harvey (who first described circulation of the blood), he devises a brace for correction of the deformity. 1641: Isaac Minnius, a German army surgeon, attempts surgical correction , the first reported open section of the sternomastoid muscle for the relief of the affection, torticollis. Note: “Affection” is used here by Finney and Hughson in 1925. Affection, from the Latin affectio, a state of feeling: a mental or emotional state or tendency ; [Archaic] a disease; ailment—synonym love. 1641: Nicolaas Tulp gives anatomy lessons, performing them on victims of public hanging; wry-neck day is hanging day. Rembrandt paints Anatomy Lesson of Nicolaas Tulp, in which only one of the council and guild members required to attend, and to pay for the privilege, actually looks at Dr. Tulp’s dissection of the executed criminal’s forearm. Tulp looks like a priest. He writes about muscular wry-neck in The Book of Monsters (1641). 1648–79: John Ward, in his diary for this time period, writes of a quack who divides “three tendons in a child’s neck, making a small incision with a lancet and elevating the tendon for fear of wounding the jugular vein and inserting a knife to divide the tendon ‘upwards ’ with a loud snap.” (David LeVay, The History of Orthopaedics) 132 Appendix 1652: Physician Tulp consults surgeon Minnius about his operation on a 12-year-old boy for congenital torticollis and describes the surgery in his Observationes. Minnius, the first to do this operation, divides “the muscle over the clavicle with a knife ‘from the ear towards the throat’.” J. F. Dieffenbach, author of “On the Cure of Wry Neck,” remarks that Minnius secures “immortality merely by thinking of this unconventional procedure,” and adds that “by placing a skin scar over the muscle,” Minnius does “everything likely to bring about a recurrence.” (LeVay) Job van Meek’ren (1611–66): Describes Florianus’ operation “on a 14-year-old boy, tied to a chair and held down” while the tendon “gave such a snap . . . as if one had plucked the string of a musical instrument.” (LeVay) 1670: Obstetrician Hendrick Van Roonhuysen, who invented a secret lever for delivering a baby stuck during birth, performs several operations for wry-neck and describes surgical correction: “It was our great good fortune that our little knife was rather broad and blunt at the back, for otherwise we might easily have damaged the windpipe and the artery, which were most plainly to be seen the following day, from which it may be sufficiently deduced how dangerous and destructive it would be to use caustic or corrosive agents . . . and how cautiously the knife must be used and everything kept ready for a severe haemorrhage, which could so easily follow.” (LeVay) 1696: Antonius Nuck uses a “head suspension appliance called the torques,” though he admits that surgery has its place. (LeVay) 1737: Von Jaeger’s inaugural dissertation at Tubingen is titled Torticollis. 1768: Samuel Sharpe uses a button-ended knife to divide the sternomastoid tendon from within outwards: “After the Incision is made, the wound is to be . . . dressed so as to prevent the extremities of the Muscle from reuniting; to which end they are to be separated from each other as much as possible by the assistance of a supporting Bandage for the Head during the whole time of the Cure, which will generally be about a Month.” (Sharpe, A Treatise on the Operations of Surgery) 1810: Johann C. F. Jorg believes that operative treatment of torticollis “might have been suitable for a cruder age, but that every case Appendix 133 could be cured by his own ingenious device in which a head-band was connected to a breastplate by a ratchet.” (LeVay) 1812: Baron Guillaume Dupuytren, a famous military surgeon, performs first closed tenotomy of the sternocleidomastoid muscle at its sternal origin. The shoulder is “brought down by tying the right hand to the right foot.” (LeVay) Several fatalities from damage to underlying vessels ensue. Open operation becomes method of choice. 1825: No surgeon yet knows the cause(s) of spasmodic torticollis. 1834: Bujalski resects, removes...