George Riddoch: the man who found Ludwig Guttmann.

STUDY DESIGN: This is a review article. OBJECTIVES: To evaluate the role played by George Riddoch in the setting up of spinal units in the UK and the appointment of Ludwig Guttmann. SETTING: Wendover, UK. METHODS: Review of the literature and the public records. RESULTS: Not applicable. CONCLUSIONS: George Riddoch's contribution to our understanding of the treatment for spinal injuries by means of his research on the patho-physiology, treatment and the setting up of spinal injury units in World Wars I and II was outstanding, especially his role in finding, appointing and supervising Ludwig Guttmann at the National Spinal Injuries Centre.

The role of the London Hospital in the development of the treatment of spinal injury.

While the role of the London Hospital in delineating diseases of the nervous system is widely accepted, its role in developing the speciality of spinal injuries in the United Kingdom has not been acknowledged. The pioneering efforts of Henry Head and George Riddoch provided the foundation for the successful treatment of patients with spinal injuries. Julian Holland-Hibbert, a trustee of the London Hospital and himself a paraplegic, by his magnificent unselfish effort made sure that patients with a spinal injury could live independent, fulfilled lives in society.

The contribution to our understanding of spinal disorders by the great Windmill Street School of Anatomy.

STUDY DESIGN: This is a review article. OBJECTIVES: The aim of this study is to investigate the contribution of the private school of anatomy, the Great Windmill Street School, in our understanding of the physiology, anatomy and pathology of the spine and spinal cord and its role in the treatment of spinal diseases in the eighteenth century. Much has been written about the Hunter brothers and Sir Charles Bell and their contribution to anatomy and medical teaching but the significant role of the Great Windmill Street School of Anatomy in our understanding of the spinal cord and the treatment of spinal disorders had not been previously explored. SETTING: Wendover, UK. METHODS: Review of the literature. RESULTS: Not applicable. CONCLUSION: The Great Windmill Street School of Anatomy was unique and fundamental in our understanding of the spine and the spinal cord and the treatment of spinal diseases. What is remarkable is that this work emanated from a private school and not a hospital or a university and it allowed an outstanding school of surgeons and physicians to carry out their work unfettered.

Spinal institutions in post-Revolutionary France.

STUDY DESIGN: Literature review. SETTING: Europe with special reference to France. OBJECTIVES: To describe the first known orthopaedic rehabilitation units founded in France in the first half of the nineteenth century for the treatment of spinal curvature and deformity and analyse their impact on the future provision of rehabilitation treatment in Europe. CONCLUSION: Despite the pioneering work of a few French orthopaedic surgeons and doctors, no long-lasting legacy remains from the establishment of innovative and holistic institutes for the treatment of spinal curvature and deformity as early as the 1830 s.

Paralysis as a result of traction for the treatment of scoliosis: a forgotten lesson from history.

STUDY DESIGN: Literature review. SETTING: Europe with special reference to France. OBJECTIVES: To review the treatment of spinal deformity in nineteenth century Europe and explain the high incidence of paralysis as a result of forceful traction of the spinal column to treat scoliosis in France as compared with other European countries. CONCLUSION: Although well described in the nineteenth century French medical literature, the dangers of forceful traction on the spinal column to correct spinal deformity were not recognized in Europe or the USA until the halofemoral traction method of treatment was used in the 1970s.

The specialty of spinal injuries in the UK.

At the outset of the Second World War, spinal units were established in the UK, but they were little more than hospitals where patients with spinal injuries were received. The treatment was deplorable, with patients typically suffering from pressure sores and renal sepsis. In the south of England, a spinal unit was not established until the appointment in 1944 of Ludwig Guttmann, who was trained in rehabilitation, neurology, neurosurgery, psychiatry and research. Guttmann devoted himself single-handedly to the care of his patients, turning and catheterising them himself. Within six months, he demonstrated that he could cure their sores and discharge them to a meaningful life. Recognition followed immediately, and doctors came from other units to learn Guttmann's methods and set up rehabilitation centres for spinal patients in the UK.

Urtication (flogging with stinging nettles) and flagellation (beating with rods) in the treatment of paralysis.

Urtication and flagellation were used as a last resort in the treatment of paralysis when all other means were exhausted, and very few cases are reported in the literature. Two cases were identified and reviewed, one of urtication (flogging with nettles) and one of flagellation (beating with rods). In both cases the symptoms were alleviated, but there was insufficient detail to evaluate the therapeutic value of each treatment.

Edward Harrison and the treatment of spinal deformities in the nineteenth century.

At the beginning of the nineteenth century, doctors and lay practitioners became interested in the treatment of spinal deformity, but it took two centuries for the specialty to become established. The provision of care was fragmented, and treatment was in the hands of physicians, surgeons, mechanics, masseurs and bonesetters. In 1837, Dr Edward Harrison founded the first infirmary for spinal diseases in London with only six beds. Harrison was a forceful character who had trained in Scotland. He held no voluntary hospital appointment and faced great opposition from the London Royal Colleges and the orthodox establishment, including Sir Charles Bell and John Shaw. This paper describes Harrison's treatment of patients afflicted by spinal deformity and analyses the medical environment of the time as well as Harrison's legacy.

The origins of sport for disabled people.

The disabled sports movement is considered to have started in 1948 when, under the aegis of Ludwig Guttmann, England hosted the first wheelchair games at Stoke Mandeville Hospital. In this review, we challenge the assumption that sport for disabled people started after the Second World War and contend that it was already practised in an organised fashion in France, Germany and the UK before and after the First World War.

George Riddoch (1888-1947): the driving force behind the treatment of spinal injuries in the UK during the Second World War.

The development of the successful treatment of spinal injuries has been inextricably linked to Sir Ludwig Guttmann and Stoke Mandeville Hospital. The role of George Riddoch has largely been ignored or mentioned merely in relation to Ludwig Guttmann and his appointment as the first Resident Medical Officer at Stoke Mandeville Hospital. Riddoch's contribution was far more significant. New material, comprising Riddoch's letters and memoranda written between 1939 and 1944, reveals his paramount involvement in the setting up of spinal injury units across the UK between 1941 and 1944, and his skill as an administrator and a clinician. Riddoch must be given credit for finding and appointing Ludwig Guttmann.