Although Spiller's operation of anterolateral chordotomy has
been often performed since 1911 for the control of intractable
pain, it may still be said to be a much neglected procedure, the
great scope of which has not been recognized by the medical
profession. Historically, Van Gehuchten in 1893 first expressed
the definite opinion that fibers conveying pain and temperature
sensation passed up the cord in Gowers' tract, although Gowers
himself had suggested this in 1879. No actual proof was afforded
until Spiller's1 fortunate observation of a patient at the
Philadelphia General Hospital in August, 1904. This patient
showed an almost complete loss of the sense of pain and
temperature in the legs, with preservation of tactile
sensibility. He was under observation for some months and died
in January, 1905. The necropsy revealed a solitary tubercle
involving the right tract of Gowers at the extreme lower end of
the thoracic cord