Traumatic Paraplegia—rationale of Therapy

ONE of the most remarkable paradoxes in the progress of modern medi-cine has been the appearance of a complex series of problems associated with the care and treatment of the traumatic paraplegic. During and following World War I relatively little thought was given to this category of patients. For one thing, the immediate shock and subsequent overwhelming infection, involving the urinary tract particularly, defied all the therapeutic efforts available to the medical profession at that time, so that the vast majority of casualties rapidly succumbed, leaving but a handful of patients to survive the ravages of their injuries. In time, even this small number became decimated as a result of recurrent infection and intercurrent disease with which we were unable to cope. But perhaps equally unfortunate were those few who, having survived the initial onslaught and subsequent complica-tions, found themselves relegated to an existence rarely more than mere vegetation. Life for the paraplegic—restricted to bed for the most part, plagued by decubiti and other distressing manifestations—presented a dismal