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Analysis of eighteenth century neurosurgical series.

BACKGROUND: The purpose of this paper is to introduce a new method of assessing historical clinical series with a view to obtaining more nuanced information from the relevant texts.

METHOD: Seven eighteenth century clinical series were analysed by determining different parameters which could then be tabulated, thus enabling the examination of correlations within and between series.

RESULTS: It could be seen that there were different patterns of practice related to different concepts of pathology and different patient characteristics. In particular, there were differences between urban and rural populations, particularly in relation to infection-related complications. On the other hand, the practice of acute surgery within the first 5 days after injury was similar across the series.

DISCUSSION: It would seem that the poor hygiene intrinsic to eighteenth century urban milieus outweighed all other factors which could affect the risk of post-traumatic infections. Traffic accidents were dangerous, not least because horses were not safe in the hands of inexpert equestrians.

CONCLUSIONS: The tabulation of clinical parameters in historical series could be a useful technique for more general application in clinical series in other fields of medicine.

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