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Lewis Albert Sayre and the Suspension Treatment of Spinal Disease

Lewis Albert Sayre and the Suspension Treatment of Spinal Disease THE LAY PUBLIC has long identified a surgeon by his or her "cutting" instruments. To incise with a scalpel, to dissect with a scissor, to sew with a needle, have been regarded as the trademarks of a busy practicing surgeon. Yet, the art and craft of surgery does not always require a knife, scissor, and needle. This was most dramatically demonstrated when Lewis Sayre authored his renowned monograph, Spinal Disease and Spinal Curvature: Their Treatment by Suspension and the Use of the Plaster of Paris Bandage in 1877. This book and its 21 albumen prints (a landmark in American medical photography since it was the first known full-length surgical text to contain actual mounted photographs) shows several patients with Pott disease and spinal curvature being treated with Sayre's tripod suspension derrick. The individual was literally hung from the device while attached to a specially constructed rope and pulley for head and axillary traction (Figure 1). Only their toes touched the ground, and this was permitted just enough to keep discomfort from becoming too serious. While under this severe traction, a snug-fitting plaster of Paris jacket was applied. Lateral traction bands were added to the suspended body according to the nature of the deformity and the plaster further applied around them. These bands were removed before the finishing layer was applied. Sayre's jacket was then worn for months at a time while realignment was, hopefully, taking place. This unique form of orthopedic surgery persisted well into the first quarter of the twentieth century. View LargeDownload There is a subtle degree of eroticism in the way the 20-year-old Jessie Brown is posed prior to her treatment by Sayre using his tripod suspension derrick. Sayre relates that following placement of a plaster of Paris jacket, she had an increase in height of "one inch and one eighth, by accurate measurement" (author's collection). Born in Bottle Hill (now Madison), NJ, in 1820, Sayre received his medical degree from New York City's College of Physicians and Surgeons (now Columbia University) in 1842. For 10 years, Sayre served as a prosector to Willard Parker (1800-1884), professor of surgery at the medical school, until his own appointment as visiting surgeon at Bellevue Hospital, New York. In 1861, Sayre became chief organizer of the Bellevue Hospital Medical College and, having acquired a reputation for his treatment of bone and joint conditions, was appointed to the orthopedic professorship. This was the first chair of orthopedic surgery in the United States, and Sayre remained until 1898 when, following the amalgamation of Bellevue Hospital Medical College and New York University, he became emeritus professor. In addition to his surgical posts, Sayre held the political position of public health officer of New York City under 4 different mayors. He improved sanitary conditions in tenements, advocated compulsory smallpox vaccination, and established quarantine regulations for the port of New York to prevent the spread of cholera and other communicable diseases. Mostly known for his skills in treating orthopedic conditions, Sayre completed the second successful resection of the hip joint for tuberculosis in the country (1852) and was the first to utilize plaster of Paris as a support for the spinal column in scoliosis and Pott disease (1876). A respected author, his other textbooks included A Practical Manual of the Treatment of Club Foot (1869) and Lectures on Orthopedic Surgery (1876). A charter member of the New York Pathological Society (1844), the New York Academy of Medicine (1847), the American Medical Association (1847), and the American Surgical Association (1880), he served as president of the American Medical Association in 1880. Sayre urged the membership of the latter organization to publish its own journal, which resulted in the establishment of the Journal of the American Medical Association (1882). He died in his New York City home in 1900. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Lewis Albert Sayre and the Suspension Treatment of Spinal Disease

Archives of Surgery , Volume 136 (1) – Jan 1, 2001

Lewis Albert Sayre and the Suspension Treatment of Spinal Disease

Abstract

THE LAY PUBLIC has long identified a surgeon by his or her "cutting" instruments. To incise with a scalpel, to dissect with a scissor, to sew with a needle, have been regarded as the trademarks of a busy practicing surgeon. Yet, the art and craft of surgery does not always require a knife, scissor, and needle. This was most dramatically demonstrated when Lewis Sayre authored his renowned monograph, Spinal Disease and Spinal Curvature: Their Treatment by Suspension and the Use of the...
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Publisher
American Medical Association
Copyright
Copyright © 2001 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.136.1.119
Publisher site
See Article on Publisher Site

Abstract

THE LAY PUBLIC has long identified a surgeon by his or her "cutting" instruments. To incise with a scalpel, to dissect with a scissor, to sew with a needle, have been regarded as the trademarks of a busy practicing surgeon. Yet, the art and craft of surgery does not always require a knife, scissor, and needle. This was most dramatically demonstrated when Lewis Sayre authored his renowned monograph, Spinal Disease and Spinal Curvature: Their Treatment by Suspension and the Use of the Plaster of Paris Bandage in 1877. This book and its 21 albumen prints (a landmark in American medical photography since it was the first known full-length surgical text to contain actual mounted photographs) shows several patients with Pott disease and spinal curvature being treated with Sayre's tripod suspension derrick. The individual was literally hung from the device while attached to a specially constructed rope and pulley for head and axillary traction (Figure 1). Only their toes touched the ground, and this was permitted just enough to keep discomfort from becoming too serious. While under this severe traction, a snug-fitting plaster of Paris jacket was applied. Lateral traction bands were added to the suspended body according to the nature of the deformity and the plaster further applied around them. These bands were removed before the finishing layer was applied. Sayre's jacket was then worn for months at a time while realignment was, hopefully, taking place. This unique form of orthopedic surgery persisted well into the first quarter of the twentieth century. View LargeDownload There is a subtle degree of eroticism in the way the 20-year-old Jessie Brown is posed prior to her treatment by Sayre using his tripod suspension derrick. Sayre relates that following placement of a plaster of Paris jacket, she had an increase in height of "one inch and one eighth, by accurate measurement" (author's collection). Born in Bottle Hill (now Madison), NJ, in 1820, Sayre received his medical degree from New York City's College of Physicians and Surgeons (now Columbia University) in 1842. For 10 years, Sayre served as a prosector to Willard Parker (1800-1884), professor of surgery at the medical school, until his own appointment as visiting surgeon at Bellevue Hospital, New York. In 1861, Sayre became chief organizer of the Bellevue Hospital Medical College and, having acquired a reputation for his treatment of bone and joint conditions, was appointed to the orthopedic professorship. This was the first chair of orthopedic surgery in the United States, and Sayre remained until 1898 when, following the amalgamation of Bellevue Hospital Medical College and New York University, he became emeritus professor. In addition to his surgical posts, Sayre held the political position of public health officer of New York City under 4 different mayors. He improved sanitary conditions in tenements, advocated compulsory smallpox vaccination, and established quarantine regulations for the port of New York to prevent the spread of cholera and other communicable diseases. Mostly known for his skills in treating orthopedic conditions, Sayre completed the second successful resection of the hip joint for tuberculosis in the country (1852) and was the first to utilize plaster of Paris as a support for the spinal column in scoliosis and Pott disease (1876). A respected author, his other textbooks included A Practical Manual of the Treatment of Club Foot (1869) and Lectures on Orthopedic Surgery (1876). A charter member of the New York Pathological Society (1844), the New York Academy of Medicine (1847), the American Medical Association (1847), and the American Surgical Association (1880), he served as president of the American Medical Association in 1880. Sayre urged the membership of the latter organization to publish its own journal, which resulted in the establishment of the Journal of the American Medical Association (1882). He died in his New York City home in 1900.

Journal

Archives of SurgeryAmerican Medical Association

Published: Jan 1, 2001

Keywords: spinal diseases

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