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.

    9/30 (page 9)
    over and get upon their feet again. You will see the child often, while standing, {>lace the hand on one or the other thigh for the “collateral transmission” of weight. The functions of both hips should be carefully examined, the pelvis should be explored by palpation and percussion as well as the ilio-costal spaces. So much for the general examination of a case for Pott’s disease before the stage of deformity. A few details now regarding the different regions. I. THE CERVICAL AND CERVICO-DOKSAL. One among the earliest symptoms observable in pa- tients who are developing disease in the bodies of the cervical or upper dorsal vertebrai is a slight torticollis or a modified opisthotonos. The child early shows a disinclination to hold the head erect or to do anything which requires rotation of this member. If any object excites the interest the whole body will turn in getting a view. Often the opisthotonos will be apparent rather than real. The head will be held in this position to prevent the chin falling toward the sternum. Besides it calls other muscles into play in giving support. This can be easily excluded from true torticollis. In the one passive movements of the head are resisted and are painful, all the muscles coming to the rescue to prevent any motion that may aggravate the sensi- tive nerves ; in the other there is no pain unless you make traction on the shortened or contracted muscles. The muscle will usually stand out in bold relief, and there is an element of rotation here not present in the other case. The facial expression — that of pain and extreme caution in movement — is very significant. The gait is likewise peculiar, the steps being short and cautiously taken, and then there is the compensating backward curve in the dorso-lumbar region which often misleads one into regarding this as the affected locality. This jjosition of the shoulders, shrugged as it were, the head seeming to sink down into them, is significant.