. Diseases of children. , with the childs headforward on the chest; then bend the childs head as farback as possible, and, if a murmur is then heard whichwas previously absent, enlarged bronchial glands murmur is caused by the pressure of the enlargedglands upon the vessels, the position of the head bringingthem into apposition with these vessels. Bronchialglands that are not enlarged will not produce this sign. TUBERCULAR MENINGITIS Tubercular meningitis is fully described under diseasesof the nervous system (see page 208). TUBERCULAR DISEASE OF THE BONES AND JOINTSPott*s disease is
. Diseases of children. , with the childs headforward on the chest; then bend the childs head as farback as possible, and, if a murmur is then heard whichwas previously absent, enlarged bronchial glands murmur is caused by the pressure of the enlargedglands upon the vessels, the position of the head bringingthem into apposition with these vessels. Bronchialglands that are not enlarged will not produce this sign. TUBERCULAR MENINGITIS Tubercular meningitis is fully described under diseasesof the nervous system (see page 208). TUBERCULAR DISEASE OF THE BONES AND JOINTSPott*s disease is tuberculosis of the spine. It may belocated in the cervical, dorsal, or lumbar regions of the TUBERCULOSIS 303 spinal column. It causes a necrosis or caries of the ver-tebrae. Symptoms.—The disease comes on insidiously. Theearliest symptoms are due to irritation of the spinal nerveroots. Pain is the most prominent of these and is referredto various parts of the body supplied by the distributionof the nerves Fig. 86.—Potts disease of the upper dorsal vertebrae. Sharp-angled kyphosis.(Clinic of von Ranke-Herzog, Munich.) In a short time there is a rigidity of the spine and thechild assumes various postures to prevent the diseasedsurfaces of the vertebrae from rubbing together. If hestoops to pick anything from the floor he does so withoutbending his back. Jumping from elevations hurts himand pulling the head av^ay from the body relieves him. 304 DISEASES OF CHILDREN FOR NURSES Soon an angular deformity called kyphosis appears atthe seat of the disease in the spine. This progressivelybecomes worse, making a permanent deformity commonlycalled hunch-hack. The tubercular process causes softening of the vertebraeand abscess formation. These abscesses vary in their location according to theseat of the lesion. In cervical Potts disease they maybe retropharyngeal; in dorsal and lumbar Potts diseasethey may point in the small of the back or burrow throughthe sheath of the
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