Spinal diseases, both structural and functional : their causes and treatment / by Usher Parsons.

  • Parsons, Usher, 1788-1868.
Date:
1843
Catalogue details

Licence: Public Domain Mark

Credit: Spinal diseases, both structural and functional : their causes and treatment / by Usher Parsons. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    The diagnosis of lateral curvature is easily understood. A plumb- line falling from the centre of the neck in the median Hne, will show the slightest deviation. The most important point to determine is the cause; whether it be diseased vertebrae, for this does no doubt exist in some rare cases, or whether it be a shortening or lameness of one hmb, a weakness in the spinal muscles, or moUities ossium or rickets. I have already adverted to the fact that where one curvature exists some length of time and destroys the equilibrium, there is an effort of nature to restore the central line of gravity, by producing a second, or compensating curve. M. Guerin remarks that an actual patho- logical curvature is never single. I have, says he, collected and described before the Academy, all the morbid specimens now in the capital, and cited all the cases of the living that I ever knew, all which show two, three, and sometimes four curvatures alternating, almost always three, very rarely two, and never one. Authors differ in opinion respecting the primary seat of lateral curvature. Mr. Shaw contends that it always commences in the loins, the dorsal curve being secondary ; and a majority of writers concur with him. Mr. Child and Mr. Coulson contend that the up- per curve is first formed. When this discrepancy first arrested my attention, I was inclined, judging from the cases I had witnessed, to concur with Mr. Child. Since then, however, I have examined several other new cases, and found them all existing in the loins. They were, however, young subjects, short of eight years old, and not yet exposed to the influence of those causes that are known to be most productive of distortion, viz., corsets and un- due exercise of one arm. On the other hand, press-men, who cause the disease by pulling violently with one arm, must cer- tainly exert the tractile force high in the back by means of the trapezius and rhomboidei muscles; and females of boarding-schools exercise chiefly one arm, all which certainly favors the idea that, in such cases at least, the dorsal vertebrae are acted on by these muscles, and are drawn into a curve. It is probable, therefore, that the curvature may begin in either the back or in the loins. When the curvature appears in one of these places, a com- pensatory one follows in the other place, giving to the spine the appearance of the letter S; and when a large lateral curvature oc- curs in the middle of the spine, there will be two smaller com- pensatory curves, one above and the other below, which will give to the spine the appearance of the Greek letter ^ Zeta. 2 t