The Rehabilitation of Patients Totally Paralyzed below the Waist: With Special Reference to Making Them Ambulatory and Capable of Earning Their Living

Abstract

REHABILITATION to any practical extent is impossible for a patient with a spinal-cord or cauda-equina injury unless he can be certain that he can have infallible control of his bowel under ordinary circumstances and that, as a result, he need not fear soiling himself unexpectedly.This desirable condition depends upon the establishment of a conditioned reflex as the result of which the large bowel empties itself only at certain prearranged times.It is necessary to know the normal physiologic anatomy of the bowel as well as the mechanism of normal defecation to understand how such a reflex can be effectively . . .