Caries of the spine : being an advance chapter of The spine its deformities, debilities, and deficiencies (third edition now in press) / by Heather Bigg.

  • Bigg, Henry Robert Heather, 1853-1911.
Date:
1902
Catalogue details

Licence: In copyright

Credit: Caries of the spine : being an advance chapter of The spine its deformities, debilities, and deficiencies (third edition now in press) / by Heather Bigg. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

    18/88 (page 16)
    Imp ly Bed on, and is, as the abscess increases, rapidly eroded ; consequently some very pronounced and angular deformity may arise long before any abscess can be detected. On the ol her hand, in cheesy caries the disease may affect and weaken the bones so slightly that there is no deformity at all, and the paralytic results of cord pressure are positively the first marked symptoms. Indeed, I have frequently seen cases that have originally been diagnosed as ones of infantile paralysis, so slight or smothered Avere all carious signs. Hence I incline very strongly to the opinion that nearly all cases of caries in which paralysis has been the first very evident symptom are those of the cheesy type. Paralysis.—The paralysis of caries is primarily motor, as indeed it is bound to be from the fact that the antero-lateral columns of the cord are the first to be involved. The motor power is nut suddenly lost, but as a rule fades slowly away. To take a typical dorsal case, there is at first mere weakness and dragging of the lower limbs in walking, which so increases that the sufferer ultimately becomes unable to stand although the limbs still retain their power of movement in recumbency; finally this latter power disappears, and there is entire impo- tence of motion. Sensibility is not up to this point deranged, as far as the spinal cord is concerned, although there may be patches of cutaneous numbness, as well as the referred pains which have previously been described as being due to the involvement of the spinal nerves in an angular curvature. Generally also by this time the disease has been checked by early breatment, and a recovery of power as gradual as its original failure begins to occur. But should this unhappily no! have been the case, the next stage is that the limits, instead of remaining passively Hail-like, begin to show mus- cular rigidity when they are handled, which rigidity slowly becomes marked and permanent. This is next followed by spasmodic contractions of the hi]), knee, and ankles, whilst ill,, adductor muscles are also similarly affected. Even at lliis stage I In' walking powers may eomnienee. to be restored, although (lie palienl presents a pitiable appearance, struggling along with bent knees, contracted heels, and legs so scissored that they can scarcely be made to pass each