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PHANTOM LIMBS OF PATIENTS WITH SPINAL CORD INJURY

PHANTOM LIMBS OF PATIENTS WITH SPINAL CORD INJURY Abstract REVIEW OF LITERATURE THE LITERATURE is replete with information on the phantom limb of the amputee. Data are also readily available which are concerned with disturbances of the body scheme. Periphery and center have thus found attention with regard to phantom phenomena; in contrast, little is known of the phantoms which accompany an injury of the spinal cord.Riddoch1 and Mayer-Gross2 are the only authors to have reported their observations on patients (and the number is relatively small) with injuries of the spinal cord. One reason for the scarcity of information may be that the survival period following trauma to the spinal cord was brief in the past. Another reason for the "apparent rarity" may be, in the words of Riddoch,1c that the "phantoms may exactly coincide with the real limbs."Recent advances of management and rehabilitation in paraplegic centers3 have made possible a study on References 1. Riddoch, G.: (a) The Reflex Functions of the Completely Divided Spinal Cord in Man, Compared with Those Associated with Less Severe Lesions , Brain 40:617, 1917 2. Riddoch The Reflex Functions of the Completely Divided Spinal Cord in Man, Compared with Those Associated with Less Severe Lesions Brain 41:264, 1918 3. Phantom Limbs and Body Shape , Riddoch Brain 64:197-222, 1941.Crossref 4. Mayer-Gross, W.: Ein Fall von Phantomarm nach Plexuszerreissung, mit einigen Bemerkungen zum Problem des Phantomgliedes überhaupt , Nervenarzt 2:65, 1929. 5. Bors, E.: Spinal Cord Injuries, Veterans Administration Technical Bulletin TB 10-503, 1948. 6. Guttmann, L.: Surgical Aspects of the Treatment of Traumatic Paraplegia , J. Bone & Joint Surg. 31-B:399-403, 1949. 7. Freeman, L. W.: Treatment of Paraplegia Resulting from Trauma to the Spinal Cord , J. A. M. A. 140:949-958 ( (July 16) ) 1949 8. 1015-1022 (July 23) 1949 9. Correction, ibid. 141:275 (Sept. 24) 1949. 10. Stone, T. T.: Phantom Limb Pain and Central Pain: Relief by Ablation of a Portion of Posterior Central Cerebral Convolution , Arch. Neurol. & Psychiat. 63:739-748 ( (May) ) 1950. 11. Guéniot: D'une hallucination du toucher (ou hétérotopie subjective des extrémitées) particulière à certains amputées , J. physiol. et path. gén. 4:416, 1861. 12. Mitchell, S. W.: (a) Phantom Limbs , Lippincotts Mag. Pop. Lit. Science 8:563-569, 1871 13. Injuries of Nerves and Their Consequences , Philadelphia, J. B. Lippincott, 1872. 14. Foerster, O.: Über das Phantomglied , Med. Klin. 27:497-500, 1931. 15. Mitchell.6a 16. Souques and Poisot, cited by Stone.4 17. Adler, A., and Hoff, H.: Beitrag zur Lehre vom Phantomgliede , Monatsschr. Psychiat. u. Neurol. 76:80-86, 1930. 18. Riechert, T.: Beobachtungen an einem Phantomarm , Nervenarzt 7:566, 1934. 19. Jung, A.: Recherches sur la physiologie pathologique des moignons d'amputation , Progr. méd. , Paris 76:275-278, 1948. 20. Kallio, K. E.: Phantom Limb of Forearm Stump Cleft by Kineplastic Surgery , Acta chir. scandinav. 99:121-132, 1949. 21. Kallio.8f 22. Betlheim, S.: Zur Lehre vom Phantomgliede , Deutsche Ztschr. Nervenh. 90:271-283, 1926. 23. Paré, A.: Oeuvres complètes d'Ambroise Paré , edited by J. F. Malgaigne, Paris, J. B. Baillière, 1840, Vol. 2, pp. 221-231. 24. Foerster, O.: Der Schmerz und seine operative Bekampfung , Nova acta Leop. Carol. 3:1-60, 1935 25. footnote 7. 26. Leriche, R.: Les douleurs des moignons d'amputation , Presse méd. 40:869-873, 1932 27. La chirurgie de la douleur , Paris, Masson et Cie, 1937. 28. Livingston, W. K.: Fantom Limb Pain: A Report of 10 Cases in Which It Was Treated by Injections of Procaine Hydrochloride Near the Thoracic Sympathetic Ganglions , Arch. Surg. 37:353-370 ( (Sept.) ) 1938 29. Pain Mechanism: A Physiologic Interpretation of Causalgia and Its Related States , New York, The Macmillan Company, 1944. 30. Gutierrez-Mahoney, C. G.: The Treatment of Painful Phantom Limb by Removal of Postcentral Cortex , J. Neurosurg. 1:156-162, 1944. 31. Horrax, G.: Experiences with Cortical Excisions for Relief of Intractable Pain in Extremities , Surgery 20:593-602, 1946. 32. Echols, D. H., and Colcough, J. A.: Abolition of Painful Phantom Foot by Resection of the Sensory Cortex , J. A. M. A. 134:1476-1477 ( (Aug. 23) ) 1947.Crossref 33. Puech, P.; Brousseau, A.; Brun, M., and Maurice, J.: Exerèse corticale rolandique dans un cas d'algohallucinose des amputés avec épilepsie du moignon , Ann. méd.-psychol. 106:45-46, 1948. 34. Waugh, O. S.; Cameron, H. F.; Howard, J. C., and Matas, J.: Prefrontal Leucotomy for Painful Phantom Limb , Canad. M. A. J. 61:364-367, 1949. 35. Foerster.11a 36. Evans, J. P.: A Study of Sensory Defects Resulting from Excision of Cerebral Substance in Humans , A. Res. Nerv. & Ment. Dis., Proc. 15:331-370, 1935. 37. Penfield, W., and Boldrey, E.: Somatic Motor and Sensory Representation in Cerebral Cortex of Man as Studied by Electrical Stimulation , Brain 60:384-443, 1937. 38. Walker, A. E.: Central Representation of Pain , A. Res. Nerv. & Ment. Dis., Proc. 23:63-85, 1943. 39. Head, H., and Holmes, G.: Sensory Disturbances from Cerebral Lesions , Brain 34:102-254, 1911. 40. Schilder, P.: Image and Appearance of the Human Body: Study in the Constructive Energies of the Psyche , Psyche Monographs No. 4, London, J. George Routledge and Sons, Ltd., and Kegan Paul, Trench, Trubner & Co., Ltd., 1935. 41. Riddoch.1c 42. Nielsen, J. M.: Agnosia, Apraxia, Aphasia: Their Value in Cerebral Localization , Ed. 2, New York, Paul B. Hoeber, Inc., 1947. 43. The patient was not questioned in this respect. 44. Bors.3a 45. Bors, E.; Engle, E. T.; Rosenquist, R. C., and Holliger, V. H.: Fertility in Paraplegic Males: A Preliminary Report of Endocrine Studies , J. Clin. Endocrinol. 10:381-398, 1950. 46. The operations were performed by Dr. John D. French, Chief of Neurosurgery. 47. Mitchell.6a,b 48. Pitres, cited by Stone.4 49. Leriche.11d 50. Ewalt, J. R.; Randall, G. C., and Morris, H. D.: The Phantom Limb , Psychosom. Med. 9:118-123, 1947. 51. Bayley, A. A., and Moersch, F. P.: Phantom Limb , Canad. M. A. J. 45:37-42, 1949. 52. Head and Holmes.13a 53. Riddoch.1c 54. Adrian, E. D.: The Effects of Injury on Mammalian Nerve Fibres , Proc. Roy. Soc., s.B , London 106:596-618, 1930. 55. Renshaw, B., and Therman, P. O.: Excitation of Intraspinal Mammalian Axons by Nerve Impulses in Adjacent Axons , Am. J. Physiol. 133:96-105, 1944. 56. Granit, R.; Leksell, L., and Skoglund, C. R.: Fibre Interaction in Injured or Compressed Region of Nerve , Brain 67:125-140, 1944. 57. Doupe, J.; Cullen, C. H., and Chance, G. Q.: Post-Traumatic Pain and the Causalgic Syndrome , J. Neurol., Neurosurg. & Psychiat. 7:33-48, 1944. 58. Nathan, P. W.: On the Pathogenesis of Causalgia in Peripheral Nerve Injuries , Brain 70:145-170, 1947. 59. Mayfield, F. H.: Causalgia , Am. J. Surg. 74:522-526, 1947. 60. McCulloch, W. S.: Physiological Processes Underlying Psychoneuroses , Proc. Roy. Soc. Med. ( (Supp.) ) 42:71-84, 1949. 61. Weinstein, A., and Kahn, R. L.: The Syndrome of Anosognosia , Arch. Neurol. & Psychiat. 64:772-791 ( (Dec.) ) 1950. 62. Stengel, E., and Steele, G. D. F.: Unawareness of Physical Disability (Anosognosia) , J. Ment. Sc. 92:379-388, 1946. 63. Riddoch.1c 64. Guéniot.5 65. Mitchell.6a,b 66. Henderson, W. R., and Smyth, G. E.: Phantom Limbs , J. Neurol., Neurosurg. & Psychiat. 11:88-112, 1948. 67. Gerstmann, J.: Problem of Imperception of Disease and of Impaired Body Territories with Organic Lesions: Relation to Body Scheme and Its Disorders , Arch. Neurol. & Psychiat. 48:890-913 ( (Dec.) ) 1942. 68. Mayer-Gross.2 69. Riddoch.1c 70. Schilder.13b 71. Nielsen.13d 72. Weinstein and Kahn.24 73. Schulte, W.: Die Psyche der Rückenmarksquerschnittsverletzten , Nervenarzt 18:28-34, 1947. 74. Mitchell.6a,b 75. Riddoch.1c 76. Henderson and Smyth.26d 77. Nielsen, J. M.: Personal communication to the author, Jan. 6, 1951. 78. Goody, W.: Sensation and Volition , Brain 72:313-339, 1949. 79. Gallinek, A.: The Phantom Limb: Its Origin and Its Relationship to the Hallucinations of Psychotic States , Am. J. Psychiat. 96:413, 1939. 80. Heusner, A. P.: Phantom Genitalia , Tr. Am. Neurol. A. 75:128-131, 1950. 81. Hyndman, O. R., and Wolkin, J.: Anterior Chordotomy: Further Observations on Physiologic Results and Optimum Manner of Performance , Arch. Neurol. & Psychiat. 50:129-148 ( (Aug.) ) 1943. 82. Davis, L., and Martin, J.: Studies upon Spinal Cord Injuries: II. The Nature and Treatment of Pain , J. Neurosurg. 4:483-491, 1947. 83. Freeman, L. W., and Heimburger, R. F.: Surgical Relief of Pain in Paraplegic Patients , Arch. Surg. 55:433-440 ( (Oct.) ) 1947. 84. Bors.3a 85. Pisetsky, J. E.: Disappearance of Painful Phantom Limbs After Electric Shock Treatment , Am. J. Psychiat. 102:599-601, 1946. 86. Hazouri, L. A., and Mueller, A. D.: Pain Threshold Studies on Paraplegic Patients , Arch. Neurol. & Psychiat. 64:607-613 ( (Nov.) ) 1950. 87. Davis and Martin.37a 88. Freeman and Heimburger.37b 89. de Saussure, R. L.: Lateral Spinothalamic Tractotomy for Relief of Pain in Cauda Equina Injury , Arch. Neurol. & Psychiat. 64:708-714 ( (Nov.) ) 1950. 90. Foerster, footnotes 7 and 11a. 91. Echlin, F.: Pain Responses on Stimulation of the Lumbar Sympathetic Chain Under Local Anesthesia , J. Neurosurg. 6:530-533, 1949. 92. Kolb, L. C.: Psychiatric Aspects of Treatment for Intractable Pain in the Phantom Limb , M. Clin. North America 34:1029-1041, 1950. 93. Lhermitte, J.: L'image de notre corps , Paris, Nouvelle revue critique, 1939. 94. Adler and Hoff.8c 95. Reichert.8d 96. Betlheim.9b 97. Charcot, cited by Lhermitte.43a 98. Thom, D. A.; von Salzen, C. F., and Fromme, A.: Symposium on Problems in Postwar Medicine: Psychological Aspects of the Paraplegic Patient , M. Clin. North America 30:473-480, 1946. 99. Schulte.30 100. Nagler, B.: Psychiatric Aspects of Cord Injury , Am. J. Psychiat. 107:49-55, 1950. 101. Grayson, M.: The Concept of "Acceptance" in Physical Rehabilitation , Mil. Surgeon 107:221-226, 1950. 102. Mueller, A. D., and Thompson, C. E.: Psychological Aspects of the Problem in Spinal Cord Injuries , Occup. Therapy 20:86-95, 1950. 103. Bors.3a 104. Shelden, C. H., and Bors, E.: Subarachnoid Alcohol Block in Paraplegia: Its Beneficial Effect on Mass Reflexes and Bladder Dysfunction , J. Neurosurg. 5:385-391, 1948. 105. Scott, W. C. M.: Some Embryological, Neurological, Psychiatric and Psychoanalytic Implications of the Body Scheme , Internat. J. Psycho-Analysis 29 (Pt. 3):141-155, 1944. 106. Flechsig, cited by Nielsen.13d http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Neurology & Psychiatry American Medical Association

PHANTOM LIMBS OF PATIENTS WITH SPINAL CORD INJURY

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American Medical Association
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Copyright © 1951 American Medical Association. All Rights Reserved.
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0096-6886
DOI
10.1001/archneurpsyc.1951.02320110075007
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Abstract

Abstract REVIEW OF LITERATURE THE LITERATURE is replete with information on the phantom limb of the amputee. Data are also readily available which are concerned with disturbances of the body scheme. Periphery and center have thus found attention with regard to phantom phenomena; in contrast, little is known of the phantoms which accompany an injury of the spinal cord.Riddoch1 and Mayer-Gross2 are the only authors to have reported their observations on patients (and the number is relatively small) with injuries of the spinal cord. One reason for the scarcity of information may be that the survival period following trauma to the spinal cord was brief in the past. Another reason for the "apparent rarity" may be, in the words of Riddoch,1c that the "phantoms may exactly coincide with the real limbs."Recent advances of management and rehabilitation in paraplegic centers3 have made possible a study on References 1. Riddoch, G.: (a) The Reflex Functions of the Completely Divided Spinal Cord in Man, Compared with Those Associated with Less Severe Lesions , Brain 40:617, 1917 2. Riddoch The Reflex Functions of the Completely Divided Spinal Cord in Man, Compared with Those Associated with Less Severe Lesions Brain 41:264, 1918 3. Phantom Limbs and Body Shape , Riddoch Brain 64:197-222, 1941.Crossref 4. Mayer-Gross, W.: Ein Fall von Phantomarm nach Plexuszerreissung, mit einigen Bemerkungen zum Problem des Phantomgliedes überhaupt , Nervenarzt 2:65, 1929. 5. Bors, E.: Spinal Cord Injuries, Veterans Administration Technical Bulletin TB 10-503, 1948. 6. Guttmann, L.: Surgical Aspects of the Treatment of Traumatic Paraplegia , J. Bone & Joint Surg. 31-B:399-403, 1949. 7. Freeman, L. W.: Treatment of Paraplegia Resulting from Trauma to the Spinal Cord , J. A. M. A. 140:949-958 ( (July 16) ) 1949 8. 1015-1022 (July 23) 1949 9. Correction, ibid. 141:275 (Sept. 24) 1949. 10. Stone, T. T.: Phantom Limb Pain and Central Pain: Relief by Ablation of a Portion of Posterior Central Cerebral Convolution , Arch. Neurol. & Psychiat. 63:739-748 ( (May) ) 1950. 11. Guéniot: D'une hallucination du toucher (ou hétérotopie subjective des extrémitées) particulière à certains amputées , J. physiol. et path. gén. 4:416, 1861. 12. Mitchell, S. W.: (a) Phantom Limbs , Lippincotts Mag. Pop. Lit. Science 8:563-569, 1871 13. Injuries of Nerves and Their Consequences , Philadelphia, J. B. Lippincott, 1872. 14. Foerster, O.: Über das Phantomglied , Med. Klin. 27:497-500, 1931. 15. Mitchell.6a 16. Souques and Poisot, cited by Stone.4 17. Adler, A., and Hoff, H.: Beitrag zur Lehre vom Phantomgliede , Monatsschr. Psychiat. u. Neurol. 76:80-86, 1930. 18. Riechert, T.: Beobachtungen an einem Phantomarm , Nervenarzt 7:566, 1934. 19. Jung, A.: Recherches sur la physiologie pathologique des moignons d'amputation , Progr. méd. , Paris 76:275-278, 1948. 20. Kallio, K. E.: Phantom Limb of Forearm Stump Cleft by Kineplastic Surgery , Acta chir. scandinav. 99:121-132, 1949. 21. Kallio.8f 22. Betlheim, S.: Zur Lehre vom Phantomgliede , Deutsche Ztschr. Nervenh. 90:271-283, 1926. 23. Paré, A.: Oeuvres complètes d'Ambroise Paré , edited by J. F. Malgaigne, Paris, J. B. Baillière, 1840, Vol. 2, pp. 221-231. 24. Foerster, O.: Der Schmerz und seine operative Bekampfung , Nova acta Leop. Carol. 3:1-60, 1935 25. footnote 7. 26. Leriche, R.: Les douleurs des moignons d'amputation , Presse méd. 40:869-873, 1932 27. La chirurgie de la douleur , Paris, Masson et Cie, 1937. 28. Livingston, W. K.: Fantom Limb Pain: A Report of 10 Cases in Which It Was Treated by Injections of Procaine Hydrochloride Near the Thoracic Sympathetic Ganglions , Arch. Surg. 37:353-370 ( (Sept.) ) 1938 29. Pain Mechanism: A Physiologic Interpretation of Causalgia and Its Related States , New York, The Macmillan Company, 1944. 30. Gutierrez-Mahoney, C. G.: The Treatment of Painful Phantom Limb by Removal of Postcentral Cortex , J. Neurosurg. 1:156-162, 1944. 31. Horrax, G.: Experiences with Cortical Excisions for Relief of Intractable Pain in Extremities , Surgery 20:593-602, 1946. 32. Echols, D. H., and Colcough, J. A.: Abolition of Painful Phantom Foot by Resection of the Sensory Cortex , J. A. M. A. 134:1476-1477 ( (Aug. 23) ) 1947.Crossref 33. Puech, P.; Brousseau, A.; Brun, M., and Maurice, J.: Exerèse corticale rolandique dans un cas d'algohallucinose des amputés avec épilepsie du moignon , Ann. méd.-psychol. 106:45-46, 1948. 34. Waugh, O. S.; Cameron, H. F.; Howard, J. C., and Matas, J.: Prefrontal Leucotomy for Painful Phantom Limb , Canad. M. A. J. 61:364-367, 1949. 35. Foerster.11a 36. Evans, J. P.: A Study of Sensory Defects Resulting from Excision of Cerebral Substance in Humans , A. Res. Nerv. & Ment. Dis., Proc. 15:331-370, 1935. 37. Penfield, W., and Boldrey, E.: Somatic Motor and Sensory Representation in Cerebral Cortex of Man as Studied by Electrical Stimulation , Brain 60:384-443, 1937. 38. Walker, A. E.: Central Representation of Pain , A. Res. Nerv. & Ment. Dis., Proc. 23:63-85, 1943. 39. Head, H., and Holmes, G.: Sensory Disturbances from Cerebral Lesions , Brain 34:102-254, 1911. 40. Schilder, P.: Image and Appearance of the Human Body: Study in the Constructive Energies of the Psyche , Psyche Monographs No. 4, London, J. George Routledge and Sons, Ltd., and Kegan Paul, Trench, Trubner & Co., Ltd., 1935. 41. Riddoch.1c 42. Nielsen, J. M.: Agnosia, Apraxia, Aphasia: Their Value in Cerebral Localization , Ed. 2, New York, Paul B. Hoeber, Inc., 1947. 43. The patient was not questioned in this respect. 44. Bors.3a 45. Bors, E.; Engle, E. T.; Rosenquist, R. C., and Holliger, V. H.: Fertility in Paraplegic Males: A Preliminary Report of Endocrine Studies , J. Clin. Endocrinol. 10:381-398, 1950. 46. The operations were performed by Dr. John D. French, Chief of Neurosurgery. 47. Mitchell.6a,b 48. Pitres, cited by Stone.4 49. Leriche.11d 50. Ewalt, J. R.; Randall, G. C., and Morris, H. D.: The Phantom Limb , Psychosom. Med. 9:118-123, 1947. 51. Bayley, A. A., and Moersch, F. P.: Phantom Limb , Canad. M. A. J. 45:37-42, 1949. 52. Head and Holmes.13a 53. Riddoch.1c 54. Adrian, E. D.: The Effects of Injury on Mammalian Nerve Fibres , Proc. Roy. Soc., s.B , London 106:596-618, 1930. 55. Renshaw, B., and Therman, P. O.: Excitation of Intraspinal Mammalian Axons by Nerve Impulses in Adjacent Axons , Am. J. Physiol. 133:96-105, 1944. 56. Granit, R.; Leksell, L., and Skoglund, C. R.: Fibre Interaction in Injured or Compressed Region of Nerve , Brain 67:125-140, 1944. 57. Doupe, J.; Cullen, C. H., and Chance, G. Q.: Post-Traumatic Pain and the Causalgic Syndrome , J. Neurol., Neurosurg. & Psychiat. 7:33-48, 1944. 58. Nathan, P. W.: On the Pathogenesis of Causalgia in Peripheral Nerve Injuries , Brain 70:145-170, 1947. 59. Mayfield, F. H.: Causalgia , Am. J. Surg. 74:522-526, 1947. 60. McCulloch, W. S.: Physiological Processes Underlying Psychoneuroses , Proc. Roy. Soc. Med. ( (Supp.) ) 42:71-84, 1949. 61. Weinstein, A., and Kahn, R. L.: The Syndrome of Anosognosia , Arch. Neurol. & Psychiat. 64:772-791 ( (Dec.) ) 1950. 62. Stengel, E., and Steele, G. D. F.: Unawareness of Physical Disability (Anosognosia) , J. Ment. Sc. 92:379-388, 1946. 63. Riddoch.1c 64. Guéniot.5 65. Mitchell.6a,b 66. Henderson, W. R., and Smyth, G. E.: Phantom Limbs , J. Neurol., Neurosurg. & Psychiat. 11:88-112, 1948. 67. Gerstmann, J.: Problem of Imperception of Disease and of Impaired Body Territories with Organic Lesions: Relation to Body Scheme and Its Disorders , Arch. Neurol. & Psychiat. 48:890-913 ( (Dec.) ) 1942. 68. Mayer-Gross.2 69. Riddoch.1c 70. Schilder.13b 71. Nielsen.13d 72. Weinstein and Kahn.24 73. Schulte, W.: Die Psyche der Rückenmarksquerschnittsverletzten , Nervenarzt 18:28-34, 1947. 74. Mitchell.6a,b 75. Riddoch.1c 76. Henderson and Smyth.26d 77. Nielsen, J. M.: Personal communication to the author, Jan. 6, 1951. 78. Goody, W.: Sensation and Volition , Brain 72:313-339, 1949. 79. Gallinek, A.: The Phantom Limb: Its Origin and Its Relationship to the Hallucinations of Psychotic States , Am. J. Psychiat. 96:413, 1939. 80. Heusner, A. P.: Phantom Genitalia , Tr. Am. Neurol. A. 75:128-131, 1950. 81. Hyndman, O. R., and Wolkin, J.: Anterior Chordotomy: Further Observations on Physiologic Results and Optimum Manner of Performance , Arch. Neurol. & Psychiat. 50:129-148 ( (Aug.) ) 1943. 82. Davis, L., and Martin, J.: Studies upon Spinal Cord Injuries: II. The Nature and Treatment of Pain , J. Neurosurg. 4:483-491, 1947. 83. Freeman, L. W., and Heimburger, R. F.: Surgical Relief of Pain in Paraplegic Patients , Arch. Surg. 55:433-440 ( (Oct.) ) 1947. 84. Bors.3a 85. Pisetsky, J. E.: Disappearance of Painful Phantom Limbs After Electric Shock Treatment , Am. J. Psychiat. 102:599-601, 1946. 86. Hazouri, L. A., and Mueller, A. D.: Pain Threshold Studies on Paraplegic Patients , Arch. Neurol. & Psychiat. 64:607-613 ( (Nov.) ) 1950. 87. Davis and Martin.37a 88. Freeman and Heimburger.37b 89. de Saussure, R. L.: Lateral Spinothalamic Tractotomy for Relief of Pain in Cauda Equina Injury , Arch. Neurol. & Psychiat. 64:708-714 ( (Nov.) ) 1950. 90. Foerster, footnotes 7 and 11a. 91. Echlin, F.: Pain Responses on Stimulation of the Lumbar Sympathetic Chain Under Local Anesthesia , J. Neurosurg. 6:530-533, 1949. 92. Kolb, L. C.: Psychiatric Aspects of Treatment for Intractable Pain in the Phantom Limb , M. Clin. North America 34:1029-1041, 1950. 93. Lhermitte, J.: L'image de notre corps , Paris, Nouvelle revue critique, 1939. 94. Adler and Hoff.8c 95. Reichert.8d 96. Betlheim.9b 97. Charcot, cited by Lhermitte.43a 98. Thom, D. A.; von Salzen, C. F., and Fromme, A.: Symposium on Problems in Postwar Medicine: Psychological Aspects of the Paraplegic Patient , M. Clin. North America 30:473-480, 1946. 99. Schulte.30 100. Nagler, B.: Psychiatric Aspects of Cord Injury , Am. J. Psychiat. 107:49-55, 1950. 101. Grayson, M.: The Concept of "Acceptance" in Physical Rehabilitation , Mil. Surgeon 107:221-226, 1950. 102. Mueller, A. D., and Thompson, C. E.: Psychological Aspects of the Problem in Spinal Cord Injuries , Occup. Therapy 20:86-95, 1950. 103. Bors.3a 104. Shelden, C. H., and Bors, E.: Subarachnoid Alcohol Block in Paraplegia: Its Beneficial Effect on Mass Reflexes and Bladder Dysfunction , J. Neurosurg. 5:385-391, 1948. 105. Scott, W. C. M.: Some Embryological, Neurological, Psychiatric and Psychoanalytic Implications of the Body Scheme , Internat. J. Psycho-Analysis 29 (Pt. 3):141-155, 1944. 106. Flechsig, cited by Nielsen.13d

Journal

A.M.A. Archives of Neurology & PsychiatryAmerican Medical Association

Published: Nov 1, 1951

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