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Show or THE cunvnn srixr. or run ccnven SPIKE. ease, the pain or uneasiness deep in the spine, with that couna tenance and habit peculiar to scrophula, will urge us to examine the spine, and if we should not find that there is a be.ginning prominence in the spinous process of one or two of the vertebrrc, yet by pressing with the fingers along the spine, some one of the spinous processes will be found to give pain perhaps, and in this case we should not delay the remedyae. The grand remedy for this disease is the making of issues or setons by the side of the affected spine. But I cannot think that the good effect of these artificial ulcers is from their acting as drains. I see them lose their efl‘ect when they be- believe pain, or in other words irritation, to be absolutely ne- cessary to the effect, and I cannot prefer the seton to the canstic because it gives less pain. If the child be young, it will only be necessary to take care that he be not carried in the usual way in the nurse's arms, but lie horizontally. If the child be more advanced, it is of the first importance that the spine be supported, and the weight of the upper part of the body taken from the diseased vertebrae. For this purpose, Le Vacher's apparatus is the best. But I may remark upon this subject, that our object should be to support, not to stretch the spine. If we find that by an apparatus we can elevate the vertebrae which have sunk, yet this should not be done, for the final cure is to be obtained by the anchylosis of the vertebrre ; 90 .-_..a.a-u- 1"}-.- "up" ,: ,liésow mum come stationar 7 -, I see, even in the first violence of the irri- tation and inflammation, a remarkable change on the disease for the better, which does not continue if the surrounding skin Once I and deeper part lose their inflammatory action. eating caustic the by found quick and remarkable relief given much deeper and broader than I intended or thought right; and I have on another occasion witnessed the remarkably good i i xt a effects of the hospital sore catching the issue, and destroying the soft parts to a great extent-In this last instance the. healthy inflammation which succeeded the sloughing of the sore made an immediate change on the disease, and the patient got quite well. In short, I conceive that the inflammation excited in the neighbourhood of the disease, (which is of the nature of a slow and sluggish scrophulous inflammation), invi- ‘ r. ~08"? «:9 -‘t'rafifln. gorates these affected parts, and reaching even to the vessels of the bone changes the nature of their action, and restores the natural influence. In this View I prefer the making of issues with the caustic of a longitudinal form by the side of the curve of the spine, first one, and when the surrounding inflammation is contract ing, and the ulcer likely to become stationary, I make another in the other side of spine, for a time neglecting the first; and afterwards I conceive it necessary to keep up a considerable degree of irritation in the one or other of the issues. I * Sec Si." James Earle, 0n the Curved Spine. 91 if they have been once destroyed, and have sunk, to separate 1 hem is to prevent the natural process of cure. Here, as in most cases, pain is the indications of mischief, while relief from it gives hopes of an amendment; now when we see a poor creature moving with much distress, seizing on every object for assistance, and leaning with his hands on his thighs to give relief to the pain of the spine, how can we. doubt but that to take off the pressure of the head and chest will promote the cure. The success of our endeavours to cure this disease in the spine, is to be judged of by the allaying of the complaint of pain, or of fatigue of the loins; by the sleep and appetite be- ing good 3 by the ceasing of involuntary spasms of the limbs, the flesh of the thighs and legs being firmer to the feelinr; lastly by the diminution of the curvature of the spine, and by the patient perceptibly growing taller. I am naturally called upon here to say a few words on rest, and its absolute necessity in this, and in many other diseases of the bones and joints. Those who are bedridden are generally suliering from disease, and the weakness induced by the disease is attributed to the confinement : but the contrary holds good when the disease is of a nature to be relieved by |
