The suspension therapy for tabes dorsalis. A case history of a therapeutic fad.
The suspension therapy of tabes dorsalis was introduced by Motschutkovsky in 1883, popularized by Charcot and Gilles de la Tourette in 1889, and subsequently rapidly and widely disseminated on the basis of enthusiastic case series. Dissemination was facilitated by endorsements of eminent neurologists, widespread publicity in professional journals and lay press, and the apparent simplicity and safety of the procedure. However, increasingly critical reports appeared, indicating much lower success rates, frequent postprocedure deterioration, and occasional serious complications. The disparity between early and later studies resulted from a placebo effect, from disregard of the natural history of the condition, from misdiagnosis, and from biased observation and reporting. By the end of 1890, the procedure was largely abandoned, despite proponents' attempts to modify the technique or to identify a more responsive subgroup of patients.