. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. e appearance. The tumor may be soft, hard, or defective \-ertebral laminte may be discerned on palpation. Thetumor enlarges and becomes tense when the patient assumes theupright posture, cries, or exerts himself. When the patient takesthe recumbent posture it becomes smaller. It also does so at eachinspiration. In some cases the functions of the individual are normal. Inothers the mobility and sensibility of the lower extremities areaffected. Deformities of the foot similar
. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. e appearance. The tumor may be soft, hard, or defective \-ertebral laminte may be discerned on palpation. Thetumor enlarges and becomes tense when the patient assumes theupright posture, cries, or exerts himself. When the patient takesthe recumbent posture it becomes smaller. It also does so at eachinspiration. In some cases the functions of the individual are normal. Inothers the mobility and sensibility of the lower extremities areaffected. Deformities of the foot similar to those seen in infantile 870 DISEASES OF THE NERVOUS SYSTEM paralysis are sometimes present. Tliere may be incontinence ofurine and feces. There are sometimes trophic disturbances, such asperforating; ulcers. These are of ^alue in the diagnosis of lumbartumors which are apparently- lipomatous in their nature and arecovered with hair (Kirmisson). In such tumors disturbances ofsensibility occurring with perforating ulcers and deformity andatrophy of a lower extremity are significant of spina Fig. 239.—.Spina bifida occulta. Course.—Spina bifida if left to itself may grow to a large size, mayburst or ulcerate, and cause death by pyogenic infection of the men-inges and cord tissue. In other cases a lineal ulcer discharges fluidand closes up several times in succession. In some cases of spinabifida the tumors remain stationary in size until late in adult rare cases spontaneous cure results by inflammation of the pedicleof a pedunculated spina bifida. Diagnosis.—The diagnosis of spina bifida is not difficult if whathas been detailed of the anatomy and symptomatology is borne inmind. ]\Iuscatello gives the following characteristics of the varicjusforms: DEFORMITIES OF THE SKULL AND SPINAL CANAL 871 Myelocystocele.—In myelocystocele there is a round tumor with awide base. The tumor is lumbosacral, elastic, translucent, andfluctuating, and does not diminish o
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