The diagnosis of Pott's disease of the spine before the stage of deformity / by V.P. Gibney.

  • Gibney, V. P. (Virgil Pendleton), 1847-1927.
Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: The diagnosis of Pott's disease of the spine before the stage of deformity / by V.P. Gibney. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    spent profitably in getting the family history. I do not mean the reply to the questions, ‘‘Are you healthy?” and “Is your husband healthy?” You waste valuable time in propounding such questions. Ascertain ail that there is to learn about transmissible diseases in both members of the family by direct and cross ex- amination. A knowledge of facts need not bias your judgment. Learn also' the personal history of the patient. If any cholera infantum followed by a slow recuperation, if rickets with its significant malnutrition, if malarial fever, if the more prominent of the exanthe- mata, such as scarlatina or diphtheria, if whooping- cough with tardy convalescence, — if any of these dis- eases, I say, come to your knowledge in getting the personal history (and it is the safer to ask about them all), you will be about ready to give an opinion. I say about ready^ because if you have obtained any facts leading you to recognize an acquired or hereditary diathesis, you will already have observed the move- ments of the child as it moves over the floor. You will also have already heard about a fall or injury, the knowledge of which came second-hand to the mother after she began to observe the very first symptoms of disability. Of course you will investigate the reported injury, and while I am as willing as any one to give a fall all the credit it deserves in the aetiology of joint diseases, I must insist on getting facts with regard to falls even. One among the first things to observe is how the patient walks, whether the spine is carried stiffly, and whether it appear shifted to one or the other side of the pelvis. You will then observe the stooping, whether the spine be held erect, or nearly so, while the thighs and legs, by sharp flexion alone, execute the act. And do you know there are some children who wear one’s patience out before you can get them to stoop? You sometimes have to lay them down forci- bly. They will surely not remain on the floor, and you can get much information by watching them roll