The Medical and surgical reporter . formity, and thei| sterno-mastoid free from contraction. And in quitea number of cases only the clavicular portion of thejji latter was implicated. y In the ordinary species of torticollis we haveI therefore to look upon the contraction of a singleI sterno-mastoid muscle as the proximate cause ofI the trouble, but know very little about its remote analogy we may infer that morbid centri- fugal innervation lies at the bottom, and we findtherefore simultaneously other symptoms of kin- »dred nature, as for instance, congenital strabismus,and the
The Medical and surgical reporter . formity, and thei| sterno-mastoid free from contraction. And in quitea number of cases only the clavicular portion of thejji latter was implicated. y In the ordinary species of torticollis we haveI therefore to look upon the contraction of a singleI sterno-mastoid muscle as the proximate cause ofI the trouble, but know very little about its remote analogy we may infer that morbid centri- fugal innervation lies at the bottom, and we findtherefore simultaneously other symptoms of kin- »dred nature, as for instance, congenital strabismus,and the characteristic attenuation to the extent ofthe nervous province concerned. In high graded cases of torticollis the deformityis very considerable and extends to the spine andthe thorax. The little girl which we operated upon in yourpresence to-day, cannot be set down as an aggra-vated case. She was too young for that. It iswith torticollis as with clubfoot, age renders themworse. The diagram Cfig. 81,) represents a furtherFig. advanced state of wryneck, and you notice itseffects upon the frame. First, it may be seen that the points of insertionof the right sterno-mastoid muscle approximateeach other, and its tensity is exhibited by theprominence of its attenuated belly. The right sideof the head is thereby drawn forward and towardthe shoulder. The face is turned left, and thechin stands above the left side of the thorax. Theright side of the face and neck is obviously atro-phied, and the line of the palpebral margins slant-ing from the left to the right. The thorax seemsto be, and actually is twisted on its axis from left 94 LECTURES, [Vol. X. to right, and lifted upward. If you fix the thoraxof such a patient and attempt to turn the head inthe opposite direction, the contracted muscle be-comes still more prominent and the patient ex-}.>eriences keen pains. And on the other hand, if ithe patient occupies the recumbent position, and !the head is suflered to he placed on
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