Posterior curvature of the spine, sometimes known as Pott's Disease, occurs most frequently in children, and is generally developed before the seventh year. Children of a scrofulous diathesis are especially liable to this affection. It is generally due to disease of the inter-vertebral cartilages and bodies of the vertebrÆ. It comes on in a slow, insidious manner, hence, it often makes serious inroads upon the spine and system before its character is even suspected.

Illustration: Fig. 1. The above portion of the spinal column shows the manner of the breaking down of the vertebrÆ from caries, and the absorption of their bony structure.
Fig. 1. The above portion of the spinal column shows the manner of the breaking down of the vertebrÆ from caries, and the absorption of their bony structure.

Generally the first point of invasion is the cartilaginous substances between the bodies of the vertebrÆ, beginning with inflammation, and finally resulting in ulceration and a breaking-down of the cartilages. It next invades the vertebrÆ themselves, and producing caries, or death and decay of the bony substance, which softens and wastes away, as shown in Fig. 1. The vertebrÆ become softened and broken down, and weight of the body pressing them together produces the deformity known as "humpback." (See Fig. 2 and Fig. 3.)

Symptoms. Among the various symptoms present in the earlier stages of the disease, and during its progress, we deem it necessary to mention only a few of the more prominent ones. While the patient is yet able to go around, the disease manifests itself by occasional pain in the bowels, stomach, and chest. Often there is a hacking cough, nervousness, lassitude, and a generally enfeebled condition of the whole system. The patient is easily fatigued; there is apparent loss of vitality, impaired appetite, a feeling of tightness across the stomach and chest, gradually declining health, and loss of flesh and strength, torpidity of the liver, deficient secretions, constipation, and morbid excretions from the kidneys. The victim, in passing chairs, tables, and other objects, instinctively places his hands upon them, and, as the disease progresses, when standing, leans upon some support whenever possible. In walking, he moves very carefully and cautiously, with elbows thrown back and chest forward, to assist the body in keeping its equilibrium. The body being kept in an [pg 899]upright position, the patient bends the knees rather than the back in stooping, as illustrated in Fig. 5, and the body is frequently supported by the hands being placed upon the thighs or knees. Sudden movements or shocks cause more or less pain.

The development of the disease then becomes rapid; suffering increases, and pain about the joints and lower extremities and muscles of the posterior part of the pelvis is experienced; numbness and coldness of the extremities are felt; locomotion becomes more difficult, and a slight projection is observed upon the back. Even in this somewhat advanced stage of the disease, when the symptoms are so apparent, many cases are shamefully neglected because an ignorant adviser says it is nothing serious and that the patient will outgrow it. The pain and tenderness not always being in the back, the inexperienced are very often misled as to the true character of the trouble. This distortion or deformity of the back now becomes painfully prominent; the diseased vertebrÆ quickly soften and waste away; the pressure upon the spinal cord increases, and paralysis of the limbs supervenes; the power of locomotion is lost, and, at last, the danger is realized and the struggle for life begins.

Illustration: Fig. 2.
Fig. 2.

Illustration: Fig. 3.
Fig. 3.

Thus, through ignorance, neglect, and improper treatment, the poor, helpless victim is doomed to a life of hideous deformity and suffering. We would, therefore, urge upon parents whose children are afflicted with this terrible disease, the great importance of placing them under the care of surgeons who have for many years made the treatment of such cases a specialty, and who have every facility and all necessary surgical appliances for insuring success in every case undertaken.

Illustration: Fig. 4. Appearance of a child suffering from Pott's disease of the spine.
Fig. 4. Appearance of a child suffering from Pott's disease of the spine.

Illustration: Fig. 5. Mode of stooping adopted by a child suffering from spinal disease.
Fig. 5. Mode of stooping adopted by a child suffering from spinal disease.

Treatment. The great essentials for the successful treatment of disease and deformities of the spine are first, a thorough knowledge of the structure and parts involved by the disease; secondly, the [pg 900]adjustment of mechanical appliances perfectly adapted to the requirements and necessities of each individual case, and the proper use of our system of "vitalization," applied to the spinal muscles to strengthen the weaker and relieve the undue contraction of the stronger. For many years our specialists have experimented, and have given the various appliances in common use in these cases most thorough and practical tests, and have found them very defective, being generally constructed upon wrong principles. The physician who sends to a mechanic for an appliance, such as are now made in the shops of most instrument makers, and uses the same, is doing himself an injustice, and barbarously torturing his patient by forcing him to wear an apparatus which is heavy, clumsy, and inevitably injurious, instead of being beneficial in its results. In the treatment of diseases and deformities of the spine, there should be no compromising; the appliance that fails to give complete support should not be worn. In our treatment of these maladies we employ only appliances which are constructed [pg 901]under the personal supervision of our specialists, upon principles dictated by common sense and the actual necessities of the case. We do not confine the body in an iron jacket. Our apparatus is light, yet durable, and is worn by the most delicate children without pain or inconvenience. It gives proper support to all parts, and is so nicely adjusted as to produce pressure only upon those points which should receive support, leaving the muscles of the spine freedom of action, thereby assisting in their development. In many hundreds of cases treated by our specialists, the disease has been entirely cured and the deformity removed. After seeing the patients and adjusting the appliances, they can generally be treated at their homes.