A practical treatise on the diseases of children / by Alfred Vogel ; translated and edited by H. Raphael.

Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases of children / by Alfred Vogel ; translated and edited by H. Raphael. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    ments, come into consideration; the further upward the disease, all the more plainly the symptoms manifest themselves on the part of the digestive, vocal, and thoracic organs. (Hence the old denomination, angina Hippocratis.) In this form of the disease, swelling of the re- gion of the neck is observed, which sometimes attains to a considerable size, and the place of curvature may thus remain hidden by it from the examining finger. These swellings, in most instances, are tense, firm, and hard, and have hence acquired the name of “ tumor albus nuchee ” (analogous to the tumor albus of the joints). The greatest danger attends the disease when it is situated on the first and second cervical vertebras, because at this point it may readily lead to compression of the medulla oblongata,* and, owing to the importance of this organ, to a speedily fatal termination. The cause is, the great mobility of the joint connections, so soon as the ligamentum transversum atlantis is destroyed or materially injured. The movements of the head are painful; they are avoided as much as possible,! and the nape and neck are kept stiff, or the movements of the head are aided by the hand. Generally the pains in the head are quite severe, and torture the patient very much, especially at night; the difficulty of swallowing is frequently great, particularly when the disease has reached the stage of the formation of retropharyngeal ab- scesses, which, owing to the magnitude which they occasionally attain, may altogether prevent the patient from partaking of food or drink. Tliis form of caries of the vertebrae, when the disease is to any degree intense, kills the patient either by the above-mentioned luxation of the upper cer\’ical vertebra, or by its invading the meninges and brain, or through exhaustive discharges. Milder forms may improve and ter- minate in recovery—as a rule, with permanent or difficult-to-be-im- proved deformity in the attitude of the head. (A kind of caput obsti- pum [torticollis] is indebted for its origin to this disease.) (3.) Spondylarthrooace lumbalis and saoralis. The site of this form, which is least frequently observed, is the lower section of the lumbar spinal column, the sacrum, and also a contiguous part of the coccyx in rarer instances. The real pains are not infre- quently preceded by unpleasant sensations in the thighs—in the form of ischias. The child lies in bed, on one side, with contracted thighs, is only able to rise with great difficulty, in which act it is obliged to support the region of the buttocks or hips with the hands (therein bearing some * [Either by the spinal column curving at a very acute angle, or by the dislocation of one body of the vertebra from the other, thereby compressing or even tearing the medulla oblongata. f The child (as in a case at present under observation), when desirous of looking at an object at its side, rotates the whole body toward it.]