Ischialgy: a study of the disease from a medical-historical view

Klinik für Allgemeine Neurochirurgie der Universität zu Köln, Cologne, Germany

The first historically verifiable description of ischialgy can be traced back to Hippocrates, who describes the illness as a hip pain at the end of the coccyx and in the gluteal area with radiation into the thigh. Detailed descriptions of the syndrome are to be found in the accounts given by Caelius Aurelianus (fifth century AD), including a description of sensibility disturbances and functions of vegitavum.

For several centuries the view has been taken that the origin of nervus ischiadicus lies in the hop area. In keeping with humoral pathological assumptions of ancient medicine, the illness is taken to be due to an accumulation of pathologically modified juices of a mucous and bilious nature. Since an unhealthy lifestyle--e.g., heavy wine drinking or sexual excesses--also was regarded as causing the disease, therapeutic measures included, first of all, body-cleansing (e.g., in the form of blood-letting).

Knowledge about pathophysiology has made only slow progress over the centuries. Equally slow in coming has been the emergence of adequate therapy. Only gradually has painkilling been resorted to, first in the form of stretching devices (e.g., stretching chairs) as well as physiotherapy. Progress in therapy has become possible only since it was realized that that suffering had its origin in a nerve compression, mostly resulting from degenerative intervertebral disc protrusion. Thanks to this insight, an operative therapy based on animal models has been developed. But it was not until 1909 that the first removal of an intervertebral disc was successfully performed, by F. Krause and H. Oppenheim.

Session VIII -- Poster Session 2
Saturday, 16 June 2001, 9:00 - 9:30 am

Sixth Annual Meeting of the International Society for the History of the Neurosciences (ISHN) and
Eighth Meeting of the European Club for the History of Neurology (ECHN)

Cologne, Germany