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130 CASES ILLUSTRATING TEE TREATMENT.
with this either, because of the severe pain in his back, not onh-
on moving it, but also when quiet. He was treated by several
physicians in private practice, both at Pola and Trieste, but none
of them could give him relief. In October 1888 he entered the
Marine Hospital, and after some weeks got rather better, when
he left. Soon the pains set in again with their former intensity,
and they became so severe that he was unable to obtain any sleep
during the night, and entirely lost his appetite. He re-entered
the hospital, and I was asked to treat him.
On the 10th of February his condition was as follows:
The patient looked very pale and worn, the cheeks were deeply
sunken, and he had a very distressed expression of countenance.
He complained of severe and constant pain in the lumbar region,
radiating down over the gluteal regions ; it was worse at night,
and he got very little rest. Sometimes the agony was so great
that he screamed out loudly.
He could not stand for more than a minute or two at a time,
and then bent forwards. He was incapable of dressing or
undressing without help.
When he was lying on the operation table, face downwards,
the upper part of the lumbar region, at the first and second ver-
tebrte, had not the normal curve, but was shghtly bent backwards.
Opposite here the pain was most intense to friction or pressure.
In this locality, also, the patient said he felt the pain greatest
without being touched. He was extremely sensitive on the sides
on the way down to the base of the spine. The great sciatic
nerves responded painfully to friction.
Progress.—Feb. 10 th. I treated him at once. As the illness
had lasted so long, I kept on for twenty-five to thirty minutes.
The pain was then considerably diminished. The reaction ensued,
and he became very weak, as if tired out, and he could not stand.
He had to be carried down.
Feb. 11th. During the previous day the patient had felt a great
deal better, and had enjoyed more rest than for several months
back, his sleep being less disturbed and the pain much easier.
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