Intraneural Injections for Rheumatoid Arthritis and Osteoarthritis with Control of Pain in Arthritis in the Knee by Pybus Paul & di Fabio Anthony

Author:Pybus, Paul & di Fabio, Anthony [Pybus, Paul]
Language: eng
Format: epub
Publisher: Arthritis Trust of America AKA Rheumatoid Disease Foundation
Published: 1984-11-22T16:00:00+00:00

CHAPTER 1 Historical

The late Professor Roger Wyburn-Mason, the co-nominee of our foundation [Arthritis Trust of America/The Rheumatoid Disease Foundtion, AKA’s for The Roger Wyburn-Mason & Jack M. Blount Foundation for the Eradication of Rheumatoid Disease], was a man of exceptional clinical acumen and observation. Way back in 1951, when I had the honour to be his House Physician, he taught me the principle that nervous activity was the prime cause of inflammation. He correctly told me that the inflammation was caused by antidromic impulses travelling along the damaged unmyelinated nerve fibres to the periphery in the joint, quoting Sir Thomas Lewis as his reference. Furthermore, he was able to demonstrate time and again that certain nerves were exquisitely tender to the touch. He gave these nerve fibres, probably unfortunately, the name “trophic nerves ”. This was received with disbelief, as there existed at the time ulcers known as “trophic ulcers ”, which had been shown conclusively to possess no nerves, as they were painless. Their proper name should have been “atrophic ulcers ”, as they had no trophic nerves in them.

This, however, was not fully recognised at the time.

For the purpose of this manual, I will stick to the term “trophic nerve ”, but the reader must understand that these nerves are identical with the C-type dorsal root fibre or Type IV of the numerical classification as sometimes used.

Further reference will be made to them in later chapters.

During my stay in Hounslow Hospital, I learnt from Dr. Wyburn-Mason that blocking these nervous impulses from their inflamed trophic nerves produced truly remarkable effects. I was taught and shown how to treat successfully, at the time, substantially untreatable conditions like sciatica, trigeminal neuralgia, migraine, intermittent claudication, facial palsy and many forms of intractable pain by means of blocking these trophic nerves. Also at this time we started to investigate methods of suppressing nervous activity to various joints in the treatment of arthritis, the most notable, to my mind, being the complete relief of pain and stiffness of the arthritic hand.

In those days, cortisone had not been fully developed and for the purpose of blocking these nerves, dehydrated alcohol was used. This procedure was extremely painful but remarkably effective in all cases.

At the end of my sojourn at Hounslow, both Wyburn-Mason and myself went our separate ways, Wyburn-Mason to greater research in an attempt to expound his ideas to an unbelieving profession, whilst I proceeded into the realms of general surgery, which took me to many corners of the globe. Although I have always been engaged in seeing and treating surgical patients, I never really forgot the teaching of Wyburn-Mason, and the remarkable results that he could produce.

79

It was not until 1978, when advancing presbyopia had whispered to me to abandon surgery and enter general practice, that I made my remarkable discovery, which I shall describe in some detail.

I had taken on the post of District Surgeon and this position included the duties of caring for the elderly indigent patients of my area.

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