Charles Lasegue and his 'Considerations on Sciatica'
O. Sugar
The eponym Lasegue sign has been applied to the increase in sciatic pain
caused by flexing the extended lower extremity on the abdomen. The sign was
never put into writing by Lasegue but by his pupils. He did not describe
the test in the usual reference, "Considerations on Sciatica," in 1864.
That article has to do with his analysis of then-current theories of
sciatica and his own clinical observations. Sciatica was divided into a
benign and a serious form, and two examples of each were described.
Emphasis was laid on the constant, fixed sciatic pain, as contrasted with
the irregular, largely nocturnal, episodes of lancinating pain. Atrophy of
leg muscles was not to be explained on the basis of disuse but by a
disorder of the nerve, which also was responsible for the typical
neuralgia, unlike that of any other part of the body except possibly
neuralgia of the brachial plexus. Treatments currently available (cupping,
vesicants, and injections of atropine solution) were unavailing. The steps
are unknown by which Lasegue came to modify his 1864 views that any sort of
flexion or extension of the lower extremity did not exacerbate the pain; in
the 1881 thesis of his pupil, Forst, that straight-leg raising sign is
described and illustrated and ascribed to his teacher, Professor Lasegue.