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

  • V. P. Gibney
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.

    6/30 (page 6)
    tainly unerring. After a year’s treatment he allowed the little patient to stand on her feet, removed the ap- paratus, and, in the presence of one or two members of the family, j)laced his hands on the child’s head, firmly pressing downward. He was no feeble specimen of a man, and the weight upon that tiny liead was more than it could bear. The patient winced under this crucial test, the limbs trembled all that day, and a rest- less ni^ht followed. Pain was felt in the back of the neck, ar.d along the spine, and in remote ])arts of the body. Several days of irritation followed, the “knuckle” began to increase in size forthwith; the doctor was greatly annoyed that the case should act in this way, his interest seemed to wane, and in three months another specialist was consulted, under whose mechanical treatment the child became paraplegic. He, skilled as he was, got the credit of producing the paralysis, and other advice was sought. For several years the loss of power continued, the deformity grew into an immense boss, and finally, on the return of power, abscesses made their appearance. Now, I have not pictured this case to censure any one; I have simply narrated it to serve as a warning. It made a profound impression on me, for 1 had so often seen that “pressure test” employed, and in earlier experience had practiced it myself. It is re- freshing to read the remarks made by Mr. Howa»d Marsh in the British Medical Journal for June 11, 1881, concerning these same dangerous experiments. His paper is full of valuable instructions, and I cannot too strongly urge its close study. The truth is that the nearer one. comes to a knowl- edge of the pathology of the disease now under discus- sion the more easily can a diagnosis be made, and the more rational will be the interpretation of the symp- toms. As J\Ir. Mar.^h says, we do not want to talk about angular curvature, or curvature of the spine. The term spondylitis, which some of my friends are attempting to introduce, is a confusing one to the stu-