A - INTRODUCTION
37
to the Spinal Unit, alternatively the patient is visited in any other specialized department
by Dr Rossier at least twice daily and thus a continued observation of the patient from
the start by the head of the Spinal Unit is guaranteed. Dr Rossier has carried out intensive
research and published valuable papers on various problems concerned with paraplegia
and has been made lecturer (Dozent) at the Medical Faculty of the University. Recently
he has received a professorship in Spinal Cord Injuries and Social Medicine at Harvard
University, Boston, U.S.A., and has been elected Director of the Spinal Unit at the
V.A. Hospital, West Roxburg, as successor of Dr Talbot.
U.S.A.
Before the entry of the U.S.A. into the Second World War after Pearl Harbour, Donald
Munro, former neurosurgeon at the City Hospital, Boston, Mass., made important and
original contributions to the problem of spinal paraplegia. Although tidal drainage was
originally introduced by Lover in 1917, at Guy's Hospital in England, it was Dr Munro
who pioneered and developed this method for the initial treatment of the paralysed
bladder, which became widely used, especially during the Second World War. Moreover,
his method of anterior rhizotomy has been accepted by many neurosurgeons for the
treatment of intractable spasticity. Munro always believed in the social rehabilitation
of paraplegic patients and became a strong advocate of their social and industrial resettle–
ment. In those years it was also Dr Deaver of the Institute for Cripples in New York
who specialized in the physical rehabilitation of patients with spinal cord afflictions,
especially polio victims.
In the U.S.A., it was the Veterans Administration of the Government which set up
Spinal Units in 8 of their Veterans Hospitals. Bors (1967) has given an excellent survey
of the development of his Centre at Long Beach, California, which had its origin in
1944-45 at tne Hammon General Hospital at Modesto, Calif., and later at the Birming–
ham General Hospital in Van Nuys, Calif. Up to 1967, altogether 2,232 patients had
passed through Bors' Unit, 2,073 °f them with traumatic lesions of the spinal cord.
Bors' views as an urologist towards the complex problem of spinal paralysis, based on such
long experience, are absolutely identical with my own as a neurological surgeon. 'It is
logical', he writes, 'that anyone, irrespective of his speciality, who wishes to serve these
patients afflicted with a neurological disorder, should familiarize himself with the basic
principles of neuroanatomy, neurophysiology and neurologic examination. ... It also
goes without saying that such a man will have to forgo some of his work connected with
his original speciality, whether this was surgery, medicine or their respective sub-
specialities, physical medicine, psychiatry, neurological surgery or neurology, because
that physician will have to devote his attention to all aspects of a patient whose require–
ments are multi-disciplinary.' Following Dr Bors' retirement his associate for many
years, Dr E.Commar became director of the Long Beach Centre. The other two larger
V.A. Spinal Injuries Centres are that at Hines V.A. Hospital, Chicago, and, especially,
that at West Roxbury, Mass., until recently under the leadership of Dr H.Talbot, a
urological surgeon who, like Bors and Commar, has been a pioneer in the urological
aspects of paraplegia. He was elected Professor at Harvard University.
